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Dr. Maurice Leland Mixson , DMD

Physician β€’ Darien, GA

Deactivated NPI 1548538770 Deactivated in NPPES Male Practitioner
Practice location in NPPES

1604 Old Cane Mill Drive
Darien, GA 31305

Phone: 9124374866

Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

This NPI Is Deactivated in NPPES

NPPES lists this NPI as deactivated as of February 14, 2018; the reason is not published. The records below are historical. They do not show whether Dr. Maurice Mixson currently practices or holds a license; check the state medical board for current license status.

NPI Enumeration Date December 02, 2011
NPI Deactivation Date February 14, 2018
NPI Active Period 2011 – 2018

Practice Location & Contact Primary Location

Practice Address

1604 Old Cane Mill Drive

Darien, GA 31305

Telephone 9124374866

NPI first issued

2011

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Compared with the same specialty in Darien and Georgia

Comparisons are not shown because NPPES lists this NPI as deactivated.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Community/Behavioral Health Primary Specialty

NUCC Taxonomy Code: 251S00000X

License # reported to NPPES GA DNOO7217

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Georgia Composite Medical Board.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
⚠️
NPI Profile Deactivated February 14, 2018

NPPES lists this NPI as deactivated as of February 14, 2018; the reason is not published.

βœ…
NPI Profile Active December 02, 2011

NPI status registered as active in NPPES database

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Practice Location (Initial Record) December 02, 2011

Registered at 1604 OLD CANE MILL DRIVE, DARIEN, GA 31305 (Tel: 9124374866)

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Business Mailing Address (Initial Record) December 02, 2011

Registered at 1604 OLD CANE MILL DR, P O BX 2031, DARIEN 31305, GA 31305 (Tel: 9124374866)

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Provider Name / Credentials (Initial Record) December 02, 2011

Recorded as MAURICE MIXSON, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 02, 2011

Community/Behavioral Health (license number reported to NPPES: GA DNOO7217)

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Initial NPI Registration & Enumeration December 02, 2011

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1548538770
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 02, 2011
Last Update: December 02, 2011
Deactivation Date: February 14, 2018

Mailing Address

1604 Old Cane Mill Dr, P O Bx 2031

Darien 31305, GA 31305

Phone: 9124374866

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.