Individual
JERRY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2315 WILDCAT RUN CT, POWELL, OH 43065-5112
(614) 406-1926
Mailing address
2315 WILDCAT RUN CT, POWELL, OH 43065-5112
(614) 406-1926
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
35082344
OH
207RX0202X
Medical Oncology Physician
Primary
35082344
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000288885
ANTHEM BC/BS
OH
05
—
2425763
—
OH
01
—
3600950
UNITED HEALTHCARE
OH
Enumeration date
05/04/2006
Last updated
02/12/2021
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