Provider Demographics
NPI:1710969464
Name:MITCHELL, STEPHEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL-50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:STE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-297-2700
Practice Address - Fax:615-269-4584
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2014-08-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN023973207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1100849099OtherUSA PPO/GEHA
KY6492024200Medicaid
TNQ006400Medicaid
TN01158928OtherAMERIGROUP TENNCARE AND AMERIVANTAGE MCR REPLACEMENT
TN1877118OtherCOVENTRY
TN30714321Medicaid
TN4166167OtherBCBS OF TN
TN4274032OtherAETNA
TN995324OtherUNITED HEALTH CARE
TNP00452870OtherMEDICARE RAILROAD
TNTN139OtherAMERICHOICE TENNCARE ONLY
TN12079652OtherMULTIPLAN/PHCS
TN2408350OtherCIGNA
258895OtherUSA MANAGED CARE
KY6492024200Medicaid