Individual
BLAKE THOMAS MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104-4637
(405) 271-5437
Mailing address
4301 WEST MARKHAM STREET #722, LITTLE ROCK, AR 72205
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5487
OK
Other
Enumeration date
07/31/2023
Last updated
10/24/2024
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