Individual
JERRY W MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 S 3RD ST, GADSDEN, AL 35901-5304
(256) 543-5200
Mailing address
PO BOX 8633, GADSDEN, AL 35902-8633
(877) 272-7799
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
00027312
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510-03610
BCBS AL
AL
01
—
P00338258
RR MEDICARE
—
Enumeration date
05/19/2006
Last updated
07/08/2007
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