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General NPI Number Information
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NPI Number | 1750339651
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Entity Type | Individual
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Provider Name | JERRY MITCHELL MD
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 02/12/2021
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Provider Practice Location Address
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Address Line | 2315 WILDCAT RUN CT
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City | POWELL
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State | OH
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Zip | 43065-5112
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Country | US
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Telephone | 614-406-1926
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Fax |
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Provider Business Mailing Address
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Address Line | 2315 WILDCAT RUN CT
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City | POWELL
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State | OH
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Zip | 43065-5112
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Country | US
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Telephone | 614-406-1926
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 35082344
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 35082344
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License Number State | OH
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