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General NPI Number Information
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NPI Number | 1316472368
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Entity Type | Organization
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Legal Business Name | TERENCE B MITCHELL MD INC
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | 2600 PARTIN DR N STE 300 SUITE 330
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City | NICEVILLE
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State | FL
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Zip | 32578-1543
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Country | US
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Telephone | 850-279-4466
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Fax | 858-502-7989
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Provider Business Mailing Address
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Address Line | 2600 PARTIN DR N STE 300 SUITE 330
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City | NICEVILLE
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State | FL
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Zip | 32578-1543
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Country | US
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Telephone | 850-279-4466
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Fax | 858-502-7989
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Authorized Official
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Title or Position | MBR
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Name | TERENCE B MITCHELL
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Credential | MD
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Telephone | 850-642-8963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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