Provider Demographics
NPI:1548230139
Name:MITCHELL, DAVID RAY (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RAY
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:918-540-7434
Mailing Address - Fax:918-540-7473
Practice Address - Street 1:200 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6830
Practice Address - Country:US
Practice Address - Phone:918-540-7434
Practice Address - Fax:918-540-7473
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2018-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK193402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
1027780OtherCIGNA BEHAVIORAL HEALTH
OK200509690AMedicaid
5305085OtherAETNA BEHAVIORAL HEALTH
OK100096500AMedicaid
OK900522214Medicare PIN
5305085OtherAETNA BEHAVIORAL HEALTH
OKC28955Medicare UPIN