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NPI Code Detail

MEDICARE: THOMAS R MITCHELL MD PC

MEDICARE: THOMAS R MITCHELL MD PC
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
1172V00000XCommunity Health Worker180983NY

General Provider Information

NPI Number : 1679883961
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMAS R MITCHELL MD PC
Provider Business Mailing Address
First Line : 425 PENNSYLVANIA AVE
Second Line :
City : ELMIRA
State : NY
Zip : 14904-1762
Country : US
Telephone Number : 607-732-1310
Fax Number : 307-733-0940
Provider Business Practice Location Address
First Line : 425 PENNSYLVANIA AVE
Second Line :
City : ELMIRA
State : NY
Zip : 14904-1762
Country : US
Telephone Number : 607-732-1310
Fax Number : 307-733-0940
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DR. THOMAS R MITCHELL
Credential : MD
Telephone Number : 607-732-1310
Provider Enumeration Date : 10/20/2010
Last Update Date : 10/20/2010

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