Provider Demographics
NPI:1568804151
Name:MITCHELL, ERIK KRAG (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:KRAG
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 1:40 S 18TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-4928
Mailing Address - Country:US
Mailing Address - Phone:913-299-1533
Mailing Address - Fax:913-912-1388
Practice Address - Street 1:40 S 18TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-4928
Practice Address - Country:US
Practice Address - Phone:913-299-1533
Practice Address - Fax:913-912-1388
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-25034207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology