Individual
DR. WILLIAM A. MITCHELL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1225 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 257-3390
Mailing address
1225 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 257-3390
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
2006009461
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006009461
MEDICAL LICENSE
MO
01
—
M5382
MEDICAL LICENSE
TX
Enumeration date
06/06/2007
Last updated
01/27/2021
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