Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackson Keith Mize, ATC

Individual provider Athletic Trainer · NPI 1881372829

Jackson Keith Mize, ATC is an Athletic Trainer in Kennesaw, Georgia. Practices as a sole proprietor and works from 2 locations. Licensed in Georgia.

Licensed in
GA
In the registry since
2023
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

590 Cobb Avenue Md #0201
Kennesaw, GA 30144
Phone: (470) 578-2786
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT003505 (GA)

Record details

NPI number1881372829
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC
Sole proprietorYes
NPI enumeratedJuly 10, 2023
Last updated in NPPESJuly 10, 2023
Certification dateJuly 10, 2023
Mailing address3091 Cobb Pkwy Nw Apt 1334, Kennesaw, GA 30152-8000

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