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Individual

CAMERON JAMES MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
520 E POINTER TRL, SUITE B, VAN BUREN, AR 72956-2304
(479) 474-7246
(479) 474-6103
Mailing address
520 E POINTER TRL, SUITE B, VAN BUREN, AR 72956-2304
(479) 474-7246
(479) 474-6103

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
15640
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15640
STATE LICENSE #
AR
01
5C789
GROUP BCBS NUMBER
AR
01
5X278
INDIVIDUAL BCBS NUMBER
AR
01
652679
UNITED HEALTHCARE ID #
AR
Enumeration date
01/16/2006
Last updated
09/03/2009
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