Provider Demographics
NPI:1528043841
Name:MITCHELL, KATHLEEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:C
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1751 GUNBARREL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7177
Mailing Address - Country:US
Mailing Address - Phone:423-778-9500
Mailing Address - Fax:423-778-9525
Practice Address - Street 1:1751 GUNBARREL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7177
Practice Address - Country:US
Practice Address - Phone:423-778-9500
Practice Address - Fax:423-778-9525
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2009-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN29700207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3827753Medicare ID - Type Unspecified
TN3827752Medicare ID - Type Unspecified