MEDICARE: JACKSON ROBINSON MITZNER MD

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
1	2084N0400X	Neurology Physician	MT225379	PA

General Provider Information

NPI Number	:	1598405631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACKSON ROBINSON MITZNER MD

Provider Business Mailing Address
First Line	:	3471 5TH AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3471 5TH AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3215
Country	:	US
Telephone Number	:	412-692-4920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2022
Last Update Date	:	05/21/2026

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