Individual
WILLIAM D MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2913 BETIN AVE, MONROE, LA 71201-7257
(318) 651-0041
(318) 651-8980
Mailing address
2913 DESIARD ST, MONROE, LA 71201-7207
(318) 388-1250
(318) 651-8980
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
135663
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135663
STATE LICENSE
AK
01
—
324084
LA STATE MEDICAL BOARD
LA
Enumeration date
05/15/2016
Last updated
10/22/2021
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