Provider Demographics
NPI:1770567315
Name:MITCHELL, PAUL A (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7951 E MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4723
Mailing Address - Country:US
Mailing Address - Phone:303-930-7800
Mailing Address - Fax:303-930-7860
Practice Address - Street 1:3027 N CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1179
Practice Address - Country:US
Practice Address - Phone:719-577-2555
Practice Address - Fax:719-667-6998
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO377312085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO28734041Medicaid
CO475768Medicare ID - Type Unspecified
CO28734041Medicaid