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Organization

MAYNOR & MITCHELL OPTICAL SHOP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM N MITCHELL M.D. (OWNER)
(256) 533-0315
Entity
Organization

Contact information

Practice address
3501 MEMORIAL PKWY SW STE 200, HUNTSVILLE, AL 35801-6901
(256) 533-0315
(256) 536-0360
Mailing address
3501 MEMORIAL PKWY SW STE 200, HUNTSVILLE, AL 35801-6901
(256) 533-0315
(256) 536-0360

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
MD21789
AL
332H00000X
Eyewear Supplier
Primary
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51511477
BCBS PROVIDER NUMBER
AL
05
529916870
AL
Enumeration date
07/15/2006
Last updated
05/28/2014
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