Provider Demographics
NPI:1649006073
Name:MITCHELL, AUSTIN SILAS
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:SILAS
Last Name:MITCHELL
Suffix:
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 1:709 E BREWER ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:OK
Mailing Address - Zip Code:74365-2237
Mailing Address - Country:US
Mailing Address - Phone:918-901-4808
Mailing Address - Fax:
Practice Address - Street 1:709 E BREWER ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:OK
Practice Address - Zip Code:74365-2237
Practice Address - Country:US
Practice Address - Phone:918-901-4808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist