Provider Demographics
NPI:1114913985
Name:MITCHELL, TORREY L (MD)
Entity Type:Individual
Prefix:
First Name:TORREY
Middle Name:L
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-7563
Mailing Address - Country:US
Mailing Address - Phone:515-267-1666
Mailing Address - Fax:
Practice Address - Street 1:1215 PLEASANT ST
Practice Address - Street 2:SUITE 300
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1416
Practice Address - Country:US
Practice Address - Phone:515-241-6500
Practice Address - Fax:515-241-8911
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA344482080P0207X
NDPT118142080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0252601Medicaid
ND15670Medicaid
ND15670Medicaid