Provider Demographics
NPI:1316012347
Name:MITCHELL, JOHN F (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049
Mailing Address - Country:US
Mailing Address - Phone:610-965-6418
Mailing Address - Fax:610-965-6382
Practice Address - Street 1:555 HARRISON ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049
Practice Address - Country:US
Practice Address - Phone:610-965-6418
Practice Address - Fax:610-965-6382
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020824E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008071950001Medicaid
PA0008071950001Medicaid
PA489480Medicare ID - Type UnspecifiedGROUP
PA132541H2CMedicare ID - Type UnspecifiedINDVIDIUAL