Deshazer, Mitchell
Deshazer, Mitchell is an sole proprietor health care provider with primary practice located at 400 N State Of Franklin Rd Room 2746, Johnson City TN 37604-6035. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Deshazer, Mitchell can be contacted via phone (423) 431-2727.Contact Information
Primary practice address
400 N State Of Franklin Rd Room 2746
Johnson City TN 37604-6035
Phone: (423) 431-2727
Fax: (423) 431-6715
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | N2058 | Texas |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | N2058 | Texas |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 7932447-1205 | Utah |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 51285 | Tennessee |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 51285 | Tennessee |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 51285 | Tennessee |
Profile Details
| NPI number | 1023276870 |
|---|---|
| LBN Legal business name | Deshazer, Mitchell |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 29th, 2008 |
| Last updated | Feb 1st, 2017 - about 8 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 | 1023276870 | NPPES |
| Tennessee | Other | P01365055 | RAILROAD MEDICARE |
| Tennessee | MEDICAID | 1023276870 | RAILROAD MEDICARE |
| Tennessee | MEDICAID | Q007623 | RAILROAD MEDICARE |
| Tennessee | MEDICAID | 7100376940 | RAILROAD MEDICARE |
| Tennessee | MEDICAID | 1023276870 | RAILROAD MEDICARE |
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