Individual
BILLY J MITCHELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
668 FALLS BLVD N, WYNNE, AR 72396-2614
(870) 238-3535
(870) 238-2427
Mailing address
668 FALLS BLVD N, WYNNE, AR 72396-2614
(870) 238-3535
(870) 238-2427
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
AR2426
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125581722
—
AR
01
—
48809
AR BLUE CROSS BLUE SHIELD
AR
01
—
71075844972396A001
WPS TRICARE SOUTH
AR
Enumeration date
11/17/2005
Last updated
01/13/2011
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