Individual
MARK C D MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 MEDICAL PARK DR, ATMORE, AL 36502-3006
(904) 805-1300
(904) 805-1302
Mailing address
PO BOX 863535, ORLANDO, FL 32886-3535
(904) 805-1300
(904) 805-1302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
10409
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009995430
—
AL
01
—
51555549
BLUE CROSS
AL
Enumeration date
06/07/2006
Last updated
04/10/2008
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