Mizell, Thomas J.
Mizell, Thomas J. is an individual health care provider with primary practice located at 2801 N Decatur Rd Suite 320, Decatur GA 30033-5949. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mizell, Thomas J. can be contacted via phone (404) 296-3111.Contact Information
Primary practice address
2801 N Decatur Rd Suite 320
Decatur GA 30033-5949
Phone: (404) 296-3111
Fax: (678) 686-9522
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 040741 | Georgia |
Profile Details
| NPI number | 1205829561 |
|---|---|
| LBN Legal business name | Mizell, Thomas J. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2005 |
| Last updated | Nov 16th, 2011 - about 13 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 | 1205829561 | NPPES |
| Georgia | MEDICAID | 055003002A |
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