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Individual

PHILLIP R MITCHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3020 KELLER BEND RD, KNOXVILLE, TN 37922-6521
(865) 690-6909
Mailing address
3020 KELLER BEND RD, KNOXVILLE, TN 37922-6521
(865) 690-6909

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
19432
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050011300
MCRR
TN
01
100020622
PHP TENNCARE
TN
01
86250
BLUE CROSS
TN
Enumeration date
01/06/2006
Last updated
08/20/2013
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