Individual
JONATHAN MIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3004 ALLISON BONNETT MEMORIAL DR, HUEYTOWN, AL 35023-2317
(205) 491-3299
Mailing address
3004 ALLISON BONNETT MEMORIAL DR, HUEYTOWN, AL 35023-2317
(205) 491-3299
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20213
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000078371
BLUE CROSS
AL
05
—
000078371
—
AL
Enumeration date
07/06/2006
Last updated
05/04/2021
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