Individual
JACK MIZELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 4TH ST SW STE 240, MASON CITY, IA 50401-2856
(641) 428-7766
Mailing address
1000 4TH ST SW, MASON CITY, IA 50401-2800
(641) 428-7000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54186
IA
208D00000X
General Practice Physician
93144
SC
Other
Enumeration date
04/13/2022
Last updated
07/15/2025
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