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OLUBANSILE A MIMIKO M.D.
NPI 1336239177
Specialist in Eastman, GA

Active since October 13, 2006
521 GRIFFIN AVE, EASTMAN, GA 31023(478) 374-4128 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Olubansile A Mimiko M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLUBANSILE A MIMIKO M.D. (NPI 1336239177) is an individual specialist in Eastman, Georgia, licensed in Georgia (050663) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1336239177
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameOLUBANSILE A MIMIKOCredential: M.D.
Location Address521 GRIFFIN AVEEastman, GA 31023-6712
Mailing AddressP O Box 4128Eastman, GA 31023-4128 · (478) 374-2742
Phone(478) 374-4128
Sole ProprietorYes
Enumeration DateOctober 13, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1336239177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in GA · 050663
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
521 GRIFFIN AVE, Eastman, GA 31023
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Other Identifiers 1

Medicare UPINH59599GA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Olubansile Mimiko's NPI number?

The NPI number for Olubansile Mimiko is 1336239177. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Where is Olubansile Mimiko located?

Olubansile Mimiko practices at 521 Griffin Ave, Eastman, GA 31023. The listed phone number is (478) 374-4128.

What is Olubansile Mimiko's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Olubansile Mimiko was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.