Provider Demographics
NPI:1831882521
Name:MITCHELL, ABIGAIL JOY (OD)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:JOY
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:110 VIRGO LN
Mailing Address - Street 2:
Mailing Address - City:POUNDING MILL
Mailing Address - State:VA
Mailing Address - Zip Code:24637-3565
Mailing Address - Country:US
Mailing Address - Phone:276-701-5540
Mailing Address - Fax:
Practice Address - Street 1:284 BEN BOLT AVE
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:VA
Practice Address - Zip Code:24651-5384
Practice Address - Country:US
Practice Address - Phone:276-385-1940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618003261152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist