Provider Demographics
NPI:1861669517
Name:MITCHELL, DAVIN (MD)
Entity Type:Individual
Prefix:
First Name:DAVIN
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1075 LAFAYETTE PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30241-3584
Mailing Address - Country:US
Mailing Address - Phone:706-593-3256
Mailing Address - Fax:706-443-5275
Practice Address - Street 1:1075 LAFAYETTE PKWY
Practice Address - Street 2:STE 100
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30241-3584
Practice Address - Country:US
Practice Address - Phone:706-593-3256
Practice Address - Fax:706-443-5275
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA63786207LP2900X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine