Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 052884 | GA |
N | 207XS0117X | Orthopaedic Spine Surgeon | 052884 | GA |
NPI | 1225086903 |
---|---|
Provider Name | Daxes M. Banit |
First Address | Warner Robins, GA 31093-8536 |
Second Address | Warner Robins, GA 31093-8536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 10/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
093299102B-PERRY | (05) | GA |
G25464 | (02) |