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Individual

HENRY STEPHEN MITCHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
450 HIGHWAY 12 W STE D, STARKVILLE, MS 39759
(662) 546-4306
Mailing address
PO BOX 59, STARKVILLE, MS 39760-0059
(662) 546-4306

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
839
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
94410
TPA
MS
Enumeration date
07/29/2011
Last updated
08/17/2023
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