Individual
MITCHELL LEE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
439 HEYMANN BLVD, LAFAYETTE, LA 70503-2616
(337) 269-0963
(337) 269-0553
Mailing address
601 W SAINT MARY BLVD, SUITE 500, LAFAYETTE, LA 70506-3568
(337) 269-0963
(337) 269-0553
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A10592
LA
Other
Enumeration date
11/28/2006
Last updated
05/03/2021
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