Mitchell, Mark Edward

Mitchell, Mark Edward is an individual health care provider with primary practice located at 2960 Tongass Avenue , Ketchikan AK 99901-5742. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mitchell, Mark Edward can be contacted via phone (907) 228-4900.

Contact Information

Primary practice address
2960 Tongass Avenue Ketchikan AK 99901-5742
Phone: (907) 228-4900
Fax: (800) 852-3264
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2681761205 Utah

Profile Details

NPI number 1689634479
LBN Legal business name Mitchell, Mark Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Jul 1st, 2016 - 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 1689634479 NPPES
New Mexico MEDICAID 52588084
New Mexico MEDICAID 82071365
New Mexico MEDICAID D0289
New Mexico MEDICAID 314804

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