DR. PARK ROBERT MITCHELL (NPI# 1619049954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619049954 |
| Entity Type | Individual |
| Full Name | DR. PARK ROBERT MITCHELL |
| Credential | M.D. |
| Practice Address |
1600 Kennesaw Due West Rd Nw Ste 620 Kennesaw GA 30152-4301 |
| Practice Telephone | 7704270171 |
| Practice Fax Number | 7704272921 |
| Mailing Telephone | 7704270171 |
| Mailing Fax Number | 7704272921 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2012-07-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
12941 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1600 KENNESAW DUE WEST RD NW STE 620 |
| City | KENNESAW |
| State | GA |
| Zip Code | 30152-4301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215976394 | John Palmer Lanier | Physical Medicine & Rehabilitation | 1600 Kennesaw Due West Rd Nw, Suite 501, Kennesaw, GA 30152-4301 | 2006-06-05 |
| 1013373711 | Adam Fackler | Chiropractor | 1600 Kennesaw Due West Rd Nw, Kennesaw, GA 30152-4301 | 2016-01-11 |
| 1760874721 | Shelton Sports and Spine | Clinic/Center | 1600 Kennesaw Due West Rd Nw, Suite 501, Kennesaw, GA 30152-4301 | 2015-03-01 |
| 1003212259 | Hallmark Dental, LLC | Dentist | 1600 Kennesaw Due West Rd Nw, 305-306, Kennesaw, GA 30152-4301 | 2014-11-17 |
| 1275819088 | Due West Integrated Health Center Physical Medicine, LLC | Physical Medicine & Rehabilitation | 1600 Kennesaw Due West Rd Nw, Suite 501, Kennesaw, GA 30152-4301 | 2011-10-25 |
| 1235378324 | Kennesaw Mountain Medical Group | Clinic/Center | 1600 Kennesaw Due West Rd Nw, Building 600 Suite 625, Kennesaw, GA 30152-4301 | 2009-02-12 |
| 1659528149 | Joseph N Grise | Chiropractor | 1600 Kennesaw Due West Rd Nw, Ste 501, Kennesaw, GA 30152-4301 | 2008-08-26 |
| 1669639373 | Park Robert Mitchell, M.d. | Obstetrics & Gynecology | 1600 Kennesaw Due West Rd Nw, Ste 620, Kennesaw, GA 30152-4301 | 2008-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821647124 | Ashley Dover | Nurse Practitioner | 1300 Ridenour Blvd, Suite 300, Kennesaw, GA 30152 | 2019-09-09 |
| 1205306891 | Lashanda Denise Moore | Nurse Practitioner | 1600 Kennesaw Due West Rd Nw #205, Kennesaw, GA 30152 | 2018-11-27 |
| 1265901094 | Focused Loving Home Care Services LLC | In Home Supportive Care | 2151 Marne Glen Nw, Kennesaw, GA 30152 | 2018-11-22 |
| 1083199152 | Raven Ashley Thomas | Behavioral Analyst | 1619 Collins Rd Nw Ste 500, Kennesaw, GA 30152 | 2018-09-25 |
| 1821592593 | Eseovhe Egborge PC | Clinic/Center | 1600 Kennesaw Due West Rd Nw Ste 205, Kennesaw, GA 30152 | 2018-03-19 |
| 1184143059 | Kennesaw Mountain Dental Associates | Dentist | 1815 Old 41 Hwy, Ste 310, Kennesaw, GA 30152 | 2017-09-12 |
| 1265955983 | Deborah Ruth Stern Compton | Registered Nurse | 1291 Stanley Rd., Kennesaw, GA 30152 | 2017-07-25 |
| 1912452939 | Mak Anesthesia Holdings LLC | Anesthesiology | 1300 Ridenour Blvd., Ste. 300, Kennesaw, GA 30152 | 2016-08-19 |
| 1528430279 | Tineka Nichol Wyckoff | Counselor | 1967 Lake Heights Circle, Kennesaw, GA 30152 | 2015-10-21 |
| 1669753992 | American Current Care Pa | Clinic/Center | 2953 Cobb Parkway, Suite 400, Kennesaw, GA 30152 | 2011-08-31 |
| Find all providers in zip 30152 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770555070 | Mojgan Khatami | Obstetrics & Gynecology | 1690 Stone Village Ln Nw, Suite401, Kennesaw, GA 30152-7776 | 2006-02-02 |
| 1225505217 | Kennesaw Health and Wellness Center LLC | Obstetrics & Gynecology | 1595 Kennesaw Due West Rd Nw Ste 100, Kennesaw, GA 30152-7640 | 2018-10-28 |
| 1669639373 | Park Robert Mitchell, M.d. | Obstetrics & Gynecology | 1600 Kennesaw Due West Rd Nw, Ste 620, Kennesaw, GA 30152-4301 | 2008-05-20 |
| 1538354071 | Georgia Gynecology | Obstetrics & Gynecology | 1690 Stone Village Ln Nw, Suite 401, Kennesaw, GA 30152-7776 | 2007-09-07 |
| 1023082930 | North Georgia Gyn | Obstetrics & Gynecology | 3450 Acworth Due West Rd Nw, Suite 380, Kennesaw, GA 30144 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558998070 | Gynecology Associates of Georgia | Obstetrics & Gynecology | 101 St Josephs Candler Dr Ste 300, Pooler, GA 31322-9588 | 2020-03-25 |
| 1295360949 | Premier Women's Gyn, LLC | Obstetrics & Gynecology | 101 Yorktown Dr Ste 224, Fayetteville, GA 30214-1578 | 2020-03-03 |
| 1073074175 | Mobile Md, LLC | Obstetrics & Gynecology | 746 Royal Springs Ln, Grovetown, GA 30813-4534 | 2019-03-29 |
| 1528565785 | Schilling Cosmetic Surgery & Aesthetics, LLC | Obstetrics & Gynecology | 1757 Rock Quarry Rd Ste A, Stockbridge, GA 30281-7303 | 2018-04-12 |
| 1356870547 | Her Wellness Center, LLC | Obstetrics & Gynecology | 1763 Highway 196 W, Hinesville, GA 31313-8013 | 2017-06-09 |
| 1245769777 | Better Health Better Life LLC | Obstetrics & Gynecology | 2398 Mount Vernon Rd Ste 150, Dunwoody, GA 30338-3064 | 2017-06-08 |
| 1699115451 | Jeffrey Alan Bernstein | Obstetrics & Gynecology | 655 Widgeon Lane, Atlanta, GA 30327 | 2013-06-26 |
| 1376899179 | Earl Edwin Sands | Obstetrics & Gynecology | 2200 Blackheath Trce, Alpharetta, GA 30005-6978 | 2012-07-30 |
| 1063788784 | Joseph Rudolph Prine Sr. | Obstetrics & Gynecology | 1216 Chennault Dr, Dublin, GA 31021-3006 | 2012-03-27 |
| 1871865113 | Candace Marvenia Tillman | Obstetrics & Gynecology | 477 Windsor St. Sw, Ste. 309, Atlanta, GA 30312 | 2012-02-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.