MEDICARE: DR, STEVE C. MITCHELL, SR.

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	332H00000X	Eyewear Supplier	1106-3	KS
2	152WC0802X	Corneal and Contact Management Optometrist
3	152WL0500X	Low Vision Rehabilitation Optometrist
4	152WP0200X	Pediatric Optometrist
5	152WS0006X	Sports Vision Optometrist
6	152WV0400X	Vision Therapy Optometrist
7	152WX0102X	Occupational Vision Optometrist
8	152W00000X	Optometrist

General Provider Information

NPI Number	:	1720098643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR, STEVE C. MITCHELL, SR.

Provider Business Mailing Address
First Line	:	624 S NATIONAL AVE
Second Line	:
City	:	FORT SCOTT
State	:	KS
Zip	:	66701-1317
Country	:	US
Telephone Number	:	620-223-6440
Fax Number	:	620-223-6988

Provider Business Practice Location Address
First Line	:	624 S NATIONAL AVE
Second Line	:
City	:	FORT SCOTT
State	:	KS
Zip	:	66701-1317
Country	:	US
Telephone Number	:	620-223-6440
Fax Number	:	620-223-6988

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. STEVE C MITCHELL SR.
Credential	:	OD
Telephone Number	:	620-223-6440

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	09/11/2025

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