Individual
DR. JEFFREY RAYMOND MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8312 KASEMAN CT NE, PRESBYTERIAN, OUTPATIENT CHILD BH CLINIC, ALBUQUERQUE, NM 87110-7639
(505) 291-5300
(505) 559-6130
Mailing address
8312 KASEMAN CT NE, CHILD AND ADOLESCENT BEHAVIORAL HEALTH CLINIC, ALBUQUERQUE, NM 87110-7639
(505) 291-5300
(505) 559-6130
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
20708
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100029450A
—
OK
01
—
2017759
CIGNA BEHAVIORAL HEALTH
—
01
—
7411192
AETNA BEHAVIORAL HEALTH
—
Enumeration date
01/19/2006
Last updated
12/13/2012
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