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Individual

DR. IDELL MARIE MITCHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
550 CONNELL PARK LN, BATON ROUGE, LA 70806-6539
(225) 924-2020
(225) 924-2809
Mailing address
550 CONNELL PARK LN, BATON ROUGE, LA 70806-6539
(225) 924-2020
(225) 924-2809

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1901-837AT
LA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2535854
LA
Enumeration date
06/13/2019
Last updated
01/27/2026
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