Individual
DR. JEFFREY A MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1108 W CHEROKEE ST, WAGONER, OK 74467-4622
(918) 485-2123
Mailing address
PO BOX 158, WAGONER, OK 74477-0158
(918) 485-2123
(918) 485-4777
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
2018
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100759760A
—
OK
Enumeration date
08/19/2006
Last updated
09/14/2012
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