Provider Demographics
NPI:1548212475
Name:MITCHELL, BRIAN WESLEY (MD)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:WESLEY
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1086A BAXTER ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6316
Mailing Address - Country:US
Mailing Address - Phone:706-353-0606
Mailing Address - Fax:706-353-0798
Practice Address - Street 1:1086A BAXTER ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6316
Practice Address - Country:US
Practice Address - Phone:706-353-0606
Practice Address - Fax:706-353-0798
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0540052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology