Individual
MR. MITCHELL S WILLCUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2871 ACTON ROAD, SUITE 100, BIRMINGHAM, AL 35243-2560
(205) 939-0023
(205) 939-4180
Mailing address
3056 HEALTHY WAY STE 100, BIRMINGHAM, AL 35243-2435
(205) 930-2925
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-131
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932943
—
AL
05
—
009955580
—
AL
05
—
009978910
—
AL
01
—
051028560
BUE CROSS - 860 MONT RD
AL
01
—
051506130
BLUE CROSS - 48 MED PARK
AL
01
—
051514497
BLUE CROSS - 2660 10TH AV
AL
Enumeration date
06/06/2006
Last updated
01/13/2023
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