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Mr. Justin T Mizelle, PA-C
Medical Physician Assistant in Johnson City, Tennessee
NPI 1356623391

Justin T Mizelle is a Medical Physician Assistant based in Johnson City, TN and is specialized in Medical. Justin T Mizelle practices in Johnson City, TN and has the professional credentials of PA-C. The NPI Number for Justin T Mizelle is 1356623391 and holds a License No. 2025 (Tennessee).

The current practice location address for Justin T Mizelle is 400 N State Of Franklin Rd, Johnson City, TN and can be reached out via phone at 888-632-1085.

Location: 400 N State Of Franklin Rd, Johnson City, TN, 37604-6035
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356623391
Provider Name
Justin T Mizelle
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
400 N State Of Franklin Rd, Johnson City, TN, 37604-6035
Phone Number
888-632-1085
Fax Number
Provider Enumeration Date
09/15/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1526919 05 TN
institution
Provider Business Practice Location Address Details
Address
400 N State Of Franklin Rd
City
Johnson City
State
Tennessee
Zip
37604-6035
Phone Number
888-632-1085
Fax Number
person
Provider Business Mailing Address Details
Address
400 N State Of Franklin Rd
City
Johnson City
State
Tennessee
Zip
37604-6035
Phone Number
888-632-1085
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
2025 (Tennessee)
Definition
Definition to come...
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