Individual
DR. DAVID MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
425 SAINT MARY ST, THIBODAUX, LA 70301-2641
(985) 447-2393
Mailing address
425 SAINT MARY ST, THIBODAUX, LA 70301-2641
(985) 447-2393
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1411-553T
LA
152WC0802X
Corneal and Contact Management Optometrist
1411-553T
LA
152WL0500X
Low Vision Rehabilitation Optometrist
1411-553T
LA
152WP0200X
Pediatric Optometrist
1411-553T
LA
152WV0400X
Vision Therapy Optometrist
1411-553T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507032
—
LA
Enumeration date
08/03/2005
Last updated
12/02/2016
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