Provider Demographics
NPI:1114323763
Name:RYAN E. MITCHELL DO PLLC
Entity Type:Organization
Organization Name:RYAN E. MITCHELL DO PLLC
Other - Org Name:ENT SPECIALTY CARE OF NEVADE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-376-3095
Mailing Address - Street 1:54 N PECOS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7329
Mailing Address - Country:US
Mailing Address - Phone:702-376-3095
Mailing Address - Fax:702-946-1687
Practice Address - Street 1:54 N PECOS RD
Practice Address - Street 2:SUITE C
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7329
Practice Address - Country:US
Practice Address - Phone:702-376-3095
Practice Address - Fax:702-946-1687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1113207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty