Mitchell, Kelly T.
Mitchell, Kelly T. is an individual health care provider with primary practice located at 3601 4Th St 2A100, Lubbock TX 79430-0002. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mitchell, Kelly T. can be contacted via phone (806) 743-2020.Contact Information
Primary practice address
3601 4Th St 2A100
Lubbock TX 79430-0002
Phone: (806) 743-2020
Fax: (806) 743-1782
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | L1942 | Texas |
Profile Details
| NPI number | 1811988751 |
|---|---|
| LBN Legal business name | Mitchell, Kelly T. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Jan 6th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811988751 | NPPES |
| Texas | MEDICAID | 144792205 | |
| Texas | MEDICAID | 144792206 | |
| Texas | MEDICAID | 81940 | |
| Texas | MEDICAID | 200013870A | |
| Texas | Other | 87410Z | |
| Texas | MEDICAID | 08534730 | |
| Texas | Other | 8G7982 | |
| Texas | MEDICAID | 101449101 | |
| Texas | Other | 81940 | |
| Texas | Other | A582 | |
| Texas | Other | 101449100 |
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