Mitchell, Jennifer T.
Mitchell, Jennifer T. is an individual health care provider with primary practice located at 3601 4Th St , Lubbock TX 79430-0002. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Mitchell, Jennifer T. can be contacted via phone (806) 743-2757.Contact Information
Primary practice address
3601 4Th St
Lubbock TX 79430-0002
Phone: (806) 743-2757
Fax: (806) 743-2563
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | J6508 | Texas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | J6508 | Texas |
Profile Details
| NPI number | 1154313054 |
|---|---|
| LBN Legal business name | Mitchell, Jennifer T. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2005 |
| Last updated | Dec 2nd, 2021 - about 4 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 | 1154313054 | NPPES |
| Texas | MEDICAID | 146288903 | |
| Texas | Other | A569 | |
| Texas | MEDICAID | 146288902 | |
| Texas | Other | 87418Z | |
| Texas | MEDICAID | 200016590A | |
| Texas | Other | 8F3612 | |
| Texas | Other | 101608100 | |
| Texas | MEDICAID | 29557887 | |
| Texas | MEDICAID | 101608101 |
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