Individual
DR. CHARLES WALTER MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3816 S CLEAR CREEK RD, SUITE E, KILLEEN, TX 76549-4400
(254) 554-8773
Mailing address
PO BOX 10308, KILLEEN, TX 76547-0308
(254) 526-5970
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F8247
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0026KV
BLUE CROSS
TX
Enumeration date
09/15/2006
Last updated
07/08/2007
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