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General NPI Number Information
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NPI Number | 1700072196
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Entity Type | Organization
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Legal Business Name | THOMAS MITCHELL MD PC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 55 FOGG RD
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City | SOUTH WEYMOUTH
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State | MA
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Zip | 02190-2432
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Country | US
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Telephone | 781-826-5429
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2315
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City | HANOVER
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State | MA
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Zip | 02339-8315
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Country | US
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Telephone | 781-826-5429
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | SUZANNE FORDE RYNNE
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Credential |
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Telephone | 781-826-5429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 76490
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License Number State | MA
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