Individual
JACOB ROBERT MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 W MICHIGAN ST, GATCH HALL SUITE CL 627, INDIANAPOLIS, IN 46202-5209
(330) 807-8029
Mailing address
1120 W MICHIGAN ST, GATCH HALL SUITE CL 627, INDIANAPOLIS, IN 46202-5209
(330) 807-8029
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11018936A
IN
Other
Enumeration date
06/16/2016
Last updated
06/27/2016
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