Mimiko, Olubansile A

Mimiko, Olubansile A is an sole proprietor health care provider with primary practice located at 521 Griffin Ave , Eastman GA 31023-6712. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Mimiko, Olubansile A can be contacted via phone (478) 374-4128.

Contact Information

Primary practice address
521 Griffin Ave Eastman GA 31023-6712
Phone: (478) 374-4128
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 050663 Georgia

Profile Details

NPI number 1336239177
LBN Legal business name Mimiko, Olubansile A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 13th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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