Provider Demographics
NPI:1629379888
Name:THOMAS F. MITTS, M.D., INC.
Entity Type:Organization
Organization Name:THOMAS F. MITTS, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:MITTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-625-4234
Mailing Address - Street 1:205 S WEST ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6112
Mailing Address - Country:US
Mailing Address - Phone:559-625-4234
Mailing Address - Fax:559-625-3124
Practice Address - Street 1:205 S WEST ST
Practice Address - Street 2:SUITE A
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-6112
Practice Address - Country:US
Practice Address - Phone:559-625-4234
Practice Address - Fax:559-625-3124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG27736208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty