Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 21327 | WV |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 21327 | WV |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 35.122976 | OH |
NPI | 1023079456 |
---|---|
Provider Name | Scott W Mitchell |
First Address | Huntington, WV 25701-4114 |
Second Address | Huntington, WV 25701-4114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 06/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2513542 | (05) | OH |
3810000797 | (05) | WV |
I03034 | (02) |