Provider Demographics
NPI:1821076647
Name:MITCHELL, JOHN D (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2750 CLAY EDWARDS DR
Mailing Address - Street 2:
Mailing Address - City:N KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3258
Mailing Address - Country:US
Mailing Address - Phone:816-561-7414
Mailing Address - Fax:816-561-6130
Practice Address - Street 1:2750 CLAY EDWARDS DR
Practice Address - Street 2:
Practice Address - City:N KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3237
Practice Address - Country:US
Practice Address - Phone:816-561-7414
Practice Address - Fax:816-561-6130
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2007-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO29188208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOC50101Medicare UPIN
MO8390000Medicare ID - Type Unspecified