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Individual

DOUGLAS MITCHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2208 N YELLOWOOD AVE, BROKEN ARROW, OK 74012-9102
(918) 286-1261
(918) 286-1265
Mailing address
2208 N YELLOWOOD AVE, BROKEN ARROW, OK 74012-9102
(918) 286-1261
(918) 286-1265

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4259
OK

Other

Enumeration date
09/29/2009
Last updated
09/29/2009
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