Healthcare Provider Details

I. General information

NPI: 1427126911
Provider Name (Legal Business Name): JAMES H MIXON MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2013 CUNNINGHAM DR SUITE 203
HAMPTON VA
23666-3306
US

IV. Provider business mailing address

2013 CUNNINGHAM DR SUITE 203
HAMPTON VA
23666-3306
US

V. Phone/Fax

Practice location:
  • Phone: 757-826-9425
  • Fax: 757-826-4634
Mailing address:
  • Phone: 757-826-9425
  • Fax: 757-826-4634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES H MIXON
Title or Position: DOCTOR
Credential: MD
Phone: 757-826-9425