Individual
DR. IRA LYMAN MITCHELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2115 CLOYD BLVD, SUITE 1, FLORENCE, AL 35630-7512
(256) 718-6858
(256) 718-6058
Mailing address
2115 CLOYD BLVD, SUITE 1, FLORENCE, AL 35630-7512
(256) 718-6858
(256) 718-6058
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00009988
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50140653
BLUE CROSS NUMBER
AL
01
—
CI3353
RAILROAD MCR NUMBER
AL
Enumeration date
10/19/2006
Last updated
07/09/2007
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