Healthcare Provider Details

I. General information

NPI: 1508523473
Provider Name (Legal Business Name): HONEST FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2021
Last Update Date: 12/28/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5381 HIGHWAY N STE 101
COTTLEVILLE MO
63304-7750
US

IV. Provider business mailing address

5381 HIGHWAY N STE 101
COTTLEVILLE MO
63304-7750
US

V. Phone/Fax

Practice location:
  • Phone: 636-875-7865
  • Fax:
Mailing address:
  • Phone: 636-875-7865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LAUREN C MITCHELL
Title or Position: OWNER
Credential: DO
Phone: 636-875-7865