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Individual

DR. TANYA MICHELLE MITCHELL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
701 CYPRESS ST, SULPHUR, LA 70663-5053
(318) 487-4982
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
020767
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1965537
LA
Enumeration date
05/21/2006
Last updated
07/08/2007
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