Individual
DR. EDWIN KYLE MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1150 S 4TH ST, HARTSVILLE, SC 29550-0705
(843) 857-1999
(843) 383-8951
Mailing address
356 WOODLANDER DR, BLYTHEWOOD, SC 29016-7621
(803) 776-5363
(803) 227-8996
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1696
SC
152WC0802X
Corneal and Contact Management Optometrist
1696
SC
152WP0200X
Pediatric Optometrist
1696
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D16962
—
SC
01
—
SC0144
MEDICARE PTAN
SC
01
—
SC3405
MEDICARE PTAN HV
SC
Enumeration date
07/27/2012
Last updated
03/23/2026
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