Individual
MR. BYRON ANTONIUS MITCHELL SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3535 SOUTHERN BLVD, TRAUMA DEPARTMENT, KETTERING, OH 45429
(937) 395-6010
(937) 522-7873
Mailing address
3535 SOUTHERN BLVD, TRAUMA DEPARTMENT, KETTERING, OH 45429-1221
(937) 395-6010
(937) 522-7873
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50003256
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0085233
—
OH
01
—
12331601
CAQH
—
Enumeration date
02/02/2011
Last updated
09/25/2013
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