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General NPI Number Information
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NPI Number | 1659377950
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Entity Type | Individual
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Provider Name | MITCHELL CARL MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 1 TRILLIUM WAY STE 302
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City | CORBIN
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State | KY
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Zip | 40701-8426
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Country | US
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Telephone | 606-528-5000
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Fax | 606-528-5113
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Provider Business Mailing Address
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Address Line | 520 TECHWOOD DRIVE SUITE 100
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City | DANVILLE
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State | KY
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Zip | 40422-8500
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Country | US
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Telephone | 859-936-9844
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Fax | 859-238-2206
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | CDR.0005430
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 37722
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License Number State | KY
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