Individual
RUSSELL MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3000 HOSPITAL BLVD, ROSWELL, GA 30076-4915
(770) 751-2567
Mailing address
5665 NEW NORTHSIDE DR NW, ATLANTA, GA 30328-5831
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
043431
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000741782B
—
GA
05
—
000741782D
—
GA
05
—
000741782E
—
GA
Enumeration date
09/25/2006
Last updated
12/15/2008
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