Individual
KYLE DARREN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1455 BELLS FERRY ROAD, SUITE 100, MARIETTA, GA 30066
(770) 421-8094
(770) 421-8096
Mailing address
15876 MEADOW KING COURT, ALPHARETTA, GA 30004
(678) 571-7684
(770) 421-8096
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
051689
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000967843E
—
GA
05
—
000967843I
—
GA
Enumeration date
11/09/2005
Last updated
03/08/2023
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