MEDICARE: MITCHELL MCCAIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	208C00000X	Colon & Rectal Surgery Physician	104163	GA

General Provider Information

NPI Number	:	1578183703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITCHELL MCCAIN MD

Provider Business Mailing Address
First Line	:	5917 E 26TH PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74114-5123
Country	:	US
Telephone Number	:	720-339-3786
Fax Number	:

Provider Business Practice Location Address
First Line	:	1802 E 19TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74104-5403
Country	:	US
Telephone Number	:	918-634-7500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2020
Last Update Date	:	05/02/2025

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Directions to “ MITCHELL MCCAIN MD” Practice Location

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