Jackson Keith Mize, ATC

Athletic Trainer · Kennesaw, GA

Individual Active NPI

NPI number 1881372829

Practice location

590 Cobb Avenue MD #0201
Kennesaw, GA 30144
Phone
(470) 578-2786

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NPI record

NPI
1881372829
Entity type
Individual (Type 1)
Enumeration date
July 10, 2023
Last updated
July 10, 2023
Certified
July 10, 2023
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Athletic Trainer Primary 2255A2300X AT003505 GA

Mailing address

3091 Cobb Pkwy NW Apt 1334
Kennesaw, GA 30152-8000
Phone
(256) 509-5364

Other practice locations (1)

  • 3200 George Busbee Pkwy NW, Kennesaw, GA 30144-4999 · (256) 509-5364

About Jackson Mize

Jackson Keith Mize, ATC is a healthcare provider registered in the NPI registry with the primary taxonomy Athletic Trainer (code 2255A2300X). The practice location is 590 Cobb Avenue MD #0201, Kennesaw, GA 30144. The NPI number 1881372829 was assigned on July 10, 2023 and the record was last updated on July 10, 2023.

Jackson Mize lists a license in the registry: #AT003505 (GA) for Athletic Trainer. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jackson Keith Mize, ATC?

The NPI number is 1881372829.

What is the phone number of Jackson Mize?

The phone number listed for the practice location is (470) 578-2786.

Where is Jackson Mize located?

590 Cobb Avenue MD #0201, Kennesaw, GA 30144.

What is the taxonomy code for Jackson Mize?

The primary taxonomy code is 2255A2300X – Athletic Trainer.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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