Individual
DR. JORDAN TYLER MIZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
PO BOX 32861, CHARLOTTE, NC 28232-2861
(704) 355-3181
(704) 446-9120
Mailing address
PO BOX 32861, CHARLOTTE, NC 28232-2861
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42032
FL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1811791510
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2025
Last updated
06/09/2026
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