Individual
DR. JACOB DONOVAN MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5115 W BASELINE RD, LAVEEN, AZ 85339-3000
(602) 283-1603
Mailing address
10765 W DEL RIO LN, AVONDALE, AZ 85323-1144
(303) 815-6373
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S027130
AZ
390200000X
Student in an Organized Health Care Education/Training Program
I025208
AZ
Other
Enumeration date
07/26/2024
Last updated
08/13/2024
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