Individual
DR. MIRANDA F MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5131 ODONOVAN DR, SUITE 500, BATON ROUGE, LA 70808-4782
(225) 374-0031
(225) 374-0120
Mailing address
5131 ODONOVAN DR, SUITE 500, BATON ROUGE, LA 70808-4782
(225) 374-0031
(225) 374-0120
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.202941
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00200212
—
MS
05
—
1097861
—
LA
Enumeration date
06/05/2008
Last updated
04/16/2014
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