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Individual

JULIA M MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2452 MAHAN DR STE 101, TALLAHASSEE, FL 32308-5377
(850) 877-2126
(850) 878-5190
Mailing address
2452 MAHAN DR STE 101, TALLAHASSEE, FL 32308-5377
(850) 877-2126
(850) 878-5190

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002304
GA
363AS0400X
Surgical Physician Assistant
Primary
PA9105804
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104589397A
PEACHSTATE
GA
05
104589397A
GA
Enumeration date
02/03/2006
Last updated
12/23/2010
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