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NPI Code Detail

MEDICARE: PETER JOSIAH TRUNG MITCHELL

MEDICARE: PETER JOSIAH TRUNG MITCHELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramKS

General Provider Information

NPI Number : 1487504585
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER JOSIAH TRUNG MITCHELL
Provider Business Mailing Address
First Line : 1016 S CARDINAL PL
Second Line :
City : OLATHE
State : KS
Zip : 66062-2140
Country : US
Telephone Number : 913-963-5286
Fax Number :
Provider Business Practice Location Address
First Line : 3901 RAINBOW BLVD
Second Line :
City : KANSAS CITY
State : KS
Zip : 66160-8500
Country : US
Telephone Number : 913-588-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2026
Last Update Date : 01/29/2026

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Directions to “ PETER JOSIAH TRUNG MITCHELL ” Practice Location

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