Mitchell, Edwin Kyle

Mitchell, Edwin Kyle is an sole proprietor health care provider with primary practice located at 1150 S 4Th St , Hartsville SC 29550-0705. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Mitchell, Edwin Kyle can be contacted via phone (843) 857-1999.

Contact Information

Primary practice address
1150 S 4Th St Hartsville SC 29550-0705
Phone: (843) 857-1999
Fax: (843) 383-8951
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1696 South Carolina
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 1696 South Carolina
Eye and Vision Services Providers / Pediatrics 152WP0200X 1696 South Carolina

Profile Details

NPI number 1700132719
LBN Legal business name Mitchell, Edwin Kyle
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2012
Last updated Apr 16th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700132719 NPPES
South Carolina MEDICAID D16962
South Carolina Other SC3405
South Carolina Other SC0144

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