Provider Demographics
NPI:1255715686
Name:MITCHELL, JUSTIN (DO)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5555
Mailing Address - Country:US
Mailing Address - Phone:918-542-6611
Mailing Address - Fax:918-540-7605
Practice Address - Street 1:200 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6830
Practice Address - Country:US
Practice Address - Phone:918-542-6611
Practice Address - Fax:918-540-7605
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK5781207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine