Healthcare Provider Details

I. General information

NPI: 1114913985
Provider Name (Legal Business Name): TORREY L MITCHELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 PLEASANT ST SUITE 300
DES MOINES IA
50309-1416
US

IV. Provider business mailing address

5609 ORCHARD DR
WEST DES MOINES IA
50266-7563
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-6500
  • Fax: 515-241-8911
Mailing address:
  • Phone: 515-267-1666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number34448
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberPT11814
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: