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Individual

CAROL JEAN MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6401 POPLAR AVENUE, #400, MEMPHIS, TN 38119
(901) 525-3086
(901) 969-1113
Mailing address
PO BOX 1000, DEPT 978, MEMPHIS, TN 38148
(901) 756-5565
(901) 756-5564

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3429717
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4293970
BCBS
TN
Enumeration date
07/05/2005
Last updated
06/15/2011
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