Individual
MR. JEFFREY JEROME MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
206 BAY AVE, RICHTON, MS 39476-2941
(601) 788-6316
(601) 788-6316
Mailing address
229 ORAL CHURCH RD, SUMRALL, MS 39482-4015
(601) 264-3448
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R832748
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0122793
—
MS
Enumeration date
07/10/2006
Last updated
11/10/2010
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