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General NPI Number Information
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NPI Number | 1174720668
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Entity Type | Individual
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Provider Name | JUSTIN S. MITCHELL D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 12770 EDGEMERE BLVD STE F
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City | EL PASO
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State | TX
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Zip | 79938-4569
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Country | US
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Telephone | 915-249-4000
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Fax | 915-206-5949
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Provider Business Mailing Address
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Address Line | 12770 EDGEMERE BLVD. #F
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City | EL PASO
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State | TX
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Zip | 79938
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Country | US
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Telephone | 915-249-4000
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Fax | 915-206-5949
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | P8276
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License Number State | TX
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