Healthcare Provider Details
I. General information
NPI: 1023938370
Provider Name (Legal Business Name): MITCHELL G JONES PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1802 6TH AVE S
BIRMINGHAM AL
35233-1932
US
IV. Provider business mailing address
2753 DRENNEN CIR
BIRMINGHAM AL
35242-4623
US
V. Phone/Fax
- Phone: 205-862-8302
- Fax:
- Phone: 205-862-8302
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 2904 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: