Organization
DR DALE MITCHUM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE G MITCHUM (OWNER/DOCTOR)
(334) 684-3007
Entity
Organization
Contact information
Practice address
100 W LAKE PROFESSIONAL PARK, SUITE #2, GENEVA, AL 36340-1203
(334) 684-3007
(334) 684-3059
Mailing address
PO BOX 900, GENEVA, AL 36340-0900
(334) 684-3007
(334) 684-3059
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12381
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51001850
BCBS BILLING NUMBER
AL
Enumeration date
10/03/2006
Last updated
03/24/2008
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