Individual
JOHN MITKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
1019022
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36156800
—
IL
Enumeration date
05/04/2015
Last updated
09/02/2025
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