Individual
DR. FREDDIE LAMONT MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
515 N SPENCE AVE, GOLDSBORO, NC 27534-4261
(919) 778-7110
(919) 778-6057
Mailing address
515 N SPENCE AVE, GOLDSBORO, NC 27534-4261
(919) 778-7110
(919) 778-6057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
926
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09625
BCBS
NC
05
—
7909625
—
NC
01
—
DA 3706
MEDICARE RAILROAD
NC
Enumeration date
06/10/2005
Last updated
08/16/2011
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