Individual
DR. JILL MARIE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
405 W GREENLAWN AVE, LANSING, MI 48910-2898
(517) 485-8217
Mailing address
405 W GREENLAWN AVE, LANSING, MI 48910-2898
(517) 485-8217
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101018129
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MI6970024
MEDICARE PTAN
MI
Enumeration date
05/12/2009
Last updated
07/19/2014
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