Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD006475 | TN |
NPI | 1033100730 |
---|---|
Provider Name | Dr. Douglas P Mitchell |
First Address | Nashville, TN 37203-1852 |
Second Address | Nashville, TN 37203-1852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B02796 | (02) | TN |