Provider Demographics
NPI:1508231978
Name:MITCHELL, ROBERT JASON (MIT - EKG)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JASON
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MIT - EKG
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:950 15TH ST RM 3C164
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2608
Mailing Address - Country:US
Mailing Address - Phone:706-733-0188
Mailing Address - Fax:706-823-3911
Practice Address - Street 1:950 15TH ST RM 3C164
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2608
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-823-3911
Is Sole Proprietor?:No
Enumeration Date:2015-12-10
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology
No174400000XOther Service ProvidersSpecialist