Individual
BENJAMIN JACOB MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 LIELMANIS AVE, 1 SOMDG, HURLBURT FIELD, FL 32544
(850) 881-2337
(850) 881-2323
Mailing address
113 LIELMANIS AVE, 1 SOMDG, HURLBURT FIELD, FL 32544
(850) 881-2337
(850) 881-2323
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD26619
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
O05961
—
OR
Enumeration date
08/03/2006
Last updated
12/22/2015
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