Individual
JAY F MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
905 VERDAE BLVD STE 101, GREENVILLE, SC 29607-4098
(864) 286-7550
(864) 286-7551
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
64845
CA
363A00000X
Physician Assistant
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3066PA
—
SC
Enumeration date
07/28/2017
Last updated
08/27/2024
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