MEDICARE: MITCHELL EYE CENTER DRS. MITCHELL, MITCHELL & ASSOC, OPTOMETRISTS P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	DA3706	OTHER	NC	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0907E	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1922003136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MITCHELL EYE CENTER DRS. MITCHELL, MITCHELL & ASSOC, OPTOMETRISTS P.A.

Provider Business Mailing Address
First Line	:	515 NORTH SPENCE AVENUE
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534
Country	:	US
Telephone Number	:	919-778-7110
Fax Number	:	919-778-6057

Provider Business Practice Location Address
First Line	:	515 NORTH SPENCE AVENUE
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534
Country	:	US
Telephone Number	:	919-778-7110
Fax Number	:	919-778-6057

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WILLIAM EARL MITCHELL
Credential	:	OD
Telephone Number	:	919-778-7110

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	10/19/2009

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