Healthcare Provider Details

I. General information

NPI: 1285389064
Provider Name (Legal Business Name): JOSEPH HENRY MITCHELL JR. FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2022
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 LEIGHTON AVE
ANNISTON AL
36207-5761
US

IV. Provider business mailing address

208 E 2ND ST
OXFORD AL
36203-1737
US

V. Phone/Fax

Practice location:
  • Phone: 256-741-6464
  • Fax: 256-741-6494
Mailing address:
  • Phone: 256-499-6866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number1-131747
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: