Provider Demographics
NPI:1821558065
Name:MITCHELL-HANDLEY, BLAIR ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:BLAIR
Middle Name:ELIZABETH
Last Name:MITCHELL-HANDLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BLAIR
Other - Middle Name:ELIZABETH
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-358-6941
Mailing Address - Fax:501-358-6951
Practice Address - Street 1:625 UNITED DR STE 420
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-7810
Practice Address - Country:US
Practice Address - Phone:501-358-6941
Practice Address - Fax:501-358-6951
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-17713207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology