Healthcare Provider Details

I. General information

NPI: 1033100730
Provider Name (Legal Business Name): DOUGLAS P MITCHELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 22ND AVE N SUITE 100
NASHVILLE TN
37203-1852
US

IV. Provider business mailing address

222 22ND AVE N SUITE 100
NASHVILLE TN
37203-1852
US

V. Phone/Fax

Practice location:
  • Phone: 615-324-2156
  • Fax: 615-284-4245
Mailing address:
  • Phone: 615-324-2156
  • Fax: 615-284-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD006475
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: