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NPI 1932840782

NPI 1932840782 : JOHN WESLEY MITCHELL JR. MD : SHERIDAN, AR

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General NPI Number Information
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    NPI Number           |    1932840782
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    Entity Type          |    Individual 
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    Provider Name        |    JOHN WESLEY MITCHELL JR. MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/05/2022
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    Last Update Date     |    07/14/2025
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Provider Practice Location Address
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    Address Line         |    506 LITTLE CREEK CUT OFF RD 
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    City                 |    SHERIDAN
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    State                |    AR
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    Zip                  |    72150-7798
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    Country              |    US
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    Telephone            |    870-942-3000
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    Fax                  |    870-942-3005
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Provider Business Mailing Address
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    Address Line         |    PO BOX 509 
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    City                 |    DERMOTT
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    State                |    AR
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    Zip                  |    71638-0509
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    Country              |    US
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    Telephone            |    870-942-3000
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    Fax                  |    870-942-3005
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    E-17554
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    License Number State |    AR
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