Healthcare Provider Details

I. General information

NPI: 1063377588
Provider Name (Legal Business Name): REGISTER MITCHELL COMPANY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 DOVER DR SE
ROME GA
30161-8016
US

IV. Provider business mailing address

45 DOVER DR SE
ROME GA
30161-8016
US

V. Phone/Fax

Practice location:
  • Phone: 706-618-1148
  • Fax:
Mailing address:
  • Phone: 706-618-1148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN REGISTER
Title or Position: OWNER
Credential: RN
Phone: 706-618-1148