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General NPI Number Information
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NPI Number | 1346443249
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Entity Type | Organization
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Legal Business Name | BILL MITCHELL, OD., PC
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 311 N BROAD ST
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City | ALBERTVILLE
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State | AL
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Zip | 35950-1725
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Country | US
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Telephone | 256-878-9181
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Fax |
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Provider Business Mailing Address
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Address Line | 311 N BROAD ST
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City | ALBERTVILLE
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State | AL
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Zip | 35950-1725
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Country | US
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Telephone | 256-878-9181
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BILL MITCHELL
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Credential | O.D.
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Telephone | 256-878-9181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S-458-TA-129
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License Number State | AL
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