Provider Demographics
NPI:1295370484
Name:MITCHELL, CHRISTOPHER BRYANT I
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRYANT
Last Name:MITCHELL
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 W WOODROW ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-2715
Mailing Address - Country:US
Mailing Address - Phone:918-565-5756
Mailing Address - Fax:
Practice Address - Street 1:7901 NE 10TH ST STE A106
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-3600
Practice Address - Country:US
Practice Address - Phone:405-731-9012
Practice Address - Fax:888-875-1829
Is Sole Proprietor?:No
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator