Provider Demographics
NPI:1083694061
Name:MITCHELL, MARK JOSEPH (PA-C)
Entity Type:Individual
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First Name:MARK
Middle Name:JOSEPH
Last Name:MITCHELL
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1776 N SCOTTSDALE RD
Mailing Address - Street 2:UNIT 368
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85252-3616
Mailing Address - Country:US
Mailing Address - Phone:480-201-5264
Mailing Address - Fax:480-393-1970
Practice Address - Street 1:5750 W THUNDERBIRD RD
Practice Address - Street 2:SUITE B200
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4660
Practice Address - Country:US
Practice Address - Phone:602-375-1700
Practice Address - Fax:602-987-1228
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2017-11-05
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Provider Licenses
StateLicense IDTaxonomies
AZ3088363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant