Mitchell, Lisa L
Mitchell, Lisa L is an individual health care provider with primary practice located at 425 Saint Mary St , Thibodaux LA 70301-2641. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Mitchell, Lisa L can be contacted via phone (985) 447-2393.Contact Information
Primary practice address
425 Saint Mary St
Thibodaux LA 70301-2641
Phone: (985) 447-2393
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 0618001392 | Virginia |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1960 | North Carolina |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1412-554T | Louisiana |
Profile Details
| NPI number | 1427059146 |
|---|---|
| LBN Legal business name | Mitchell, Lisa L |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2005 |
| Last updated | Dec 2nd, 2016 - about 8 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 | 1427059146 | NPPES |
| Other | 4K179C398 | MEDICARE-UNSPECIFIED | |
| MEDICAID | 1010421 | MEDICARE-UNSPECIFIED |
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