Individual
JACOB ANDERSON MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 GENEVIEVE CT STE A, PEACHTREE CITY, GA 30269-4868
(770) 486-1818
Mailing address
100 GENEVIEVE CT STE A, PEACHTREE CITY, GA 30269-4868
(770) 486-1818
(770) 486-7303
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11837364-1205
UT
207Q00000X
Family Medicine Physician
Primary
91704
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/15/2019
Last updated
07/22/2025
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