Individual
CHARLENE KAY MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
401 E CHESTNUT ST UNIT 310, LOUISVILLE, KY 40202-5703
(502) 589-6788
(502) 589-5093
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0320
(502) 588-0326
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26295
KY
208000000X
Pediatrics Physician
26295
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64262959
—
KY
Enumeration date
05/24/2005
Last updated
04/06/2017
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