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Individual

MR. PHILLIP DAKOTAH MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1090 ARNOLD DR, LR AFB, AR 72099-4933
(501) 987-3080
Mailing address
1090 ARNOLD DR, LR AFB, AR 72099-4933
(501) 987-3080

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
025056
NY

Other

Enumeration date
06/20/2018
Last updated
04/05/2022
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