Mitchell, Edwin Kyle
Mitchell, Edwin Kyle is an sole proprietor health care provider with primary practice located at 1150 S 4Th St , Hartsville SC 29550-0705. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Mitchell, Edwin Kyle can be contacted via phone (843) 857-1999.Contact Information
Primary practice address
1150 S 4Th St
Hartsville SC 29550-0705
Phone: (843) 857-1999
Fax: (843) 383-8951
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1696 | South Carolina |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 1696 | South Carolina |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 1696 | South Carolina |
Profile Details
| NPI number | 1700132719 |
|---|---|
| LBN Legal business name | Mitchell, Edwin Kyle |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 27th, 2012 |
| Last updated | Apr 16th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700132719 | NPPES |
| South Carolina | MEDICAID | D16962 | |
| South Carolina | Other | SC3405 | |
| South Carolina | Other | SC0144 |
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