Mitchell, Jeffrey A
Mitchell, Jeffrey A is an individual health care provider with primary practice located at 1108 W Cherokee St , Wagoner OK 74467-4622. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Mitchell, Jeffrey A can be contacted via phone (918) 485-2123.Contact Information
Primary practice address
1108 W Cherokee St
Wagoner OK 74467-4622
Phone: (918) 485-2123
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 2018 | Oklahoma |
Profile Details
| NPI number | 1750495206 |
|---|---|
| LBN Legal business name | Mitchell, Jeffrey A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Sep 14th, 2012 - about 12 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 | 1750495206 | NPPES |
| Oklahoma | MEDICAID | 100759760A |
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