Provider Demographics
NPI:1922003136
Name:MITCHELL EYE CENTER DRS. MITCHELL, MITCHELL & ASSOC, OPTOMETRISTS P.A.
Entity Type:Organization
Organization Name:MITCHELL EYE CENTER DRS. MITCHELL, MITCHELL & ASSOC, OPTOMETRISTS P.A.
Other - Org Name:MITCHELL EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-778-7110
Mailing Address - Street 1:515 NORTH SPENCE AVENUE
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534
Mailing Address - Country:US
Mailing Address - Phone:919-778-7110
Mailing Address - Fax:919-778-6057
Practice Address - Street 1:515 NORTH SPENCE AVENUE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534
Practice Address - Country:US
Practice Address - Phone:919-778-7110
Practice Address - Fax:919-778-6057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-0907EMedicaid
NC0907EOtherBCBS
NCDA3706OtherMEDICARE RAILROAD
NC2469326Medicare ID - Type Unspecified
NCDA3706OtherMEDICARE RAILROAD