Individual
DR. JAYME LEIGH MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
22 PINE ST, BRISTOL, CT 06010-6948
(860) 584-8291
(860) 581-8354
Mailing address
22 PINE ST, BRISTOL, CT 06010-6948
(860) 584-8291
(860) 581-8354
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
053732
CT
207R00000X
Internal Medicine Physician
55713
MN
Other
Enumeration date
05/09/2009
Last updated
03/24/2020
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