Provider Demographics
NPI:1467629881
Name:MITCHELL, WESLEY GREGORY JR (MSA,CSA)
Entity Type:Individual
Prefix:MR
First Name:WESLEY
Middle Name:GREGORY
Last Name:MITCHELL
Suffix:JR
Gender:M
Credentials:MSA,CSA
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Mailing Address - Street 1:11340 LAKEFIELD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1714
Mailing Address - Country:US
Mailing Address - Phone:404-771-4728
Mailing Address - Fax:404-393-9515
Practice Address - Street 1:11340 LAKEFIELD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1714
Practice Address - Country:US
Practice Address - Phone:770-629-8289
Practice Address - Fax:404-393-9515
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2023-12-05
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Provider Licenses
StateLicense IDTaxonomies
GA3245363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical