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NPI Code Detail

MEDICARE: DR. KENT MITCHELL M.D.

MEDICARE: DR. KENT MITCHELL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0014XInterventional Pain Medicine PhysicianM0830TX

General Provider Information

NPI Number : 1619170453
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENT MITCHELL M.D.
Provider Business Mailing Address
First Line : 1000 LIPSCOMB ST STE 110
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3181
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 LIPSCOMB ST STE 110
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3181
Country : US
Telephone Number : 817-348-8600
Fax Number : 817-348-8602
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2007
Last Update Date : 06/18/2020

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Directions to “ DR. KENT MITCHELL M.D.” Practice Location

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