Provider Demographics
NPI:1932177334
Name:MITCHELL, ARTHUR B (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:B
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 S MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-3310
Mailing Address - Country:US
Mailing Address - Phone:570-288-0284
Mailing Address - Fax:570-288-2130
Practice Address - Street 1:141 S MAPLE AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-3310
Practice Address - Country:US
Practice Address - Phone:570-288-0284
Practice Address - Fax:570-288-2130
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031584E207Q00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023162Medicaid
PA1023162Medicaid
PA456935NWDMedicare ID - Type Unspecified