Provider Demographics
NPI:1548277809
Name:MITCHELL, RODERICK LEE (MD)
Entity type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:LEE
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:303 WEBB ST
Mailing Address - Street 2:
Mailing Address - City:DAINGERFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:75638-1651
Mailing Address - Country:US
Mailing Address - Phone:903-645-3932
Mailing Address - Fax:903-645-7565
Practice Address - Street 1:303 WEBB ST
Practice Address - Street 2:
Practice Address - City:DAINGERFIELD
Practice Address - State:TX
Practice Address - Zip Code:75638-1651
Practice Address - Country:US
Practice Address - Phone:903-645-3932
Practice Address - Fax:903-645-7565
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine