Provider Demographics
NPI:1245238567
Name:MITCHELL, CHARLES AUSTIN III (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:AUSTIN
Last Name:MITCHELL
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:5505 EDMONDSON PIKE
Mailing Address - Street 2:10
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-5872
Mailing Address - Country:US
Mailing Address - Phone:615-810-8730
Mailing Address - Fax:615-810-8731
Practice Address - Street 1:5505 EDMONDSON PIKE
Practice Address - Street 2:10
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5872
Practice Address - Country:US
Practice Address - Phone:615-810-8730
Practice Address - Fax:615-810-8731
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2017-11-21
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Provider Licenses
StateLicense IDTaxonomies
TN37546207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2075994OtherCIGNA PIN
TN810600182OtherGREAT WEST HEALTHCARE PIN
TN810600182OtherSIGNATURE HEALTH ALLIANCE
TN810600182OtherPHCS NETWORK PIN
TN810600182OtherUNITED HEALTHCARE PIN
TN4066881OtherBLUE CROSS PIN
TNH84577OtherHEALTHSPRING PIN
TN3885689Medicaid
TN7961488OtherAETNA PIN
TN810600182OtherONE HEALTH PLAN, INC PIN
TN2130841OtherFIRST HEALTH NETWORK PIN
TN810600182OtherONE HEALTH PLAN, INC PIN
TN810600182OtherSIGNATURE HEALTH ALLIANCE