Individual
ISAAC MITTENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2331 NEW HOLT RD, PADUCAH, KY 42001-7404
(270) 441-4777
(270) 441-4780
Mailing address
2331 NEW HOLT RD, PADUCAH, KY 42001-7404
(270) 441-4777
(270) 441-4777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41002
SC
Other
Enumeration date
05/11/2017
Last updated
04/08/2021
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