Park Robert Mitchell, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

PARK ROBERT MITCHELL, M.D.

Practice address

1600 Kennesaw Due West Rd NW
Ste 620
Kennesaw, GA 30152-4301

Phone

(770) 427-0171

Fax

(770) 427-2921

NPI assigned

May 20, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Park Robert Mitchell, M.D.

Title

President

Phone

(770) 427-0171

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1669639373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 KENNESAW DUE WEST RD NW",
            "address_2": "STE 620",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524301",
            "telephone_number": "770-427-0171",
            "fax_number": "770-427-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 KENNESAW DUE WEST RD NW",
            "address_2": "STE 620",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524301",
            "telephone_number": "770-427-0171",
            "fax_number": "770-427-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK ROBERT MITCHELL, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "PARK",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-427-0171",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gynecology Physician in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.