Adiele, Jacquelene Mitchell
Adiele, Jacquelene Mitchell is an sole proprietor health care provider with primary practice located at 3816 S Clear Creek Rd Suite A, Killeen TX 76549-4400. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Adiele, Jacquelene Mitchell can be contacted via phone (254) 200-2748.Contact Information
Primary practice address
3816 S Clear Creek Rd Suite A
Killeen TX 76549-4400
Phone: (254) 200-2748
Fax: (254) 200-2757
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | J2678 | Texas |
Profile Details
| NPI number | 1609896497 |
|---|---|
| LBN Legal business name | Adiele, Jacquelene Mitchell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Dec 17th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609896497 | NPPES |
| Texas | MEDICAID | 034049902 | |
| Texas | Other | 1609896497 | |
| Texas | Other | TXB158053 | |
| Texas | Other | J2678 |
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