Individual
BENNETT MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
540 N NELLIS BLVD, LAS VEGAS, NV 89110-5368
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5199
(702) 259-0128
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7323
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639140205
—
NV
05
—
2019532
—
NV
Enumeration date
01/31/2006
Last updated
11/18/2024
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