Provider Demographics
NPI:1619945060
Name:MITCHELL, WILLIAM CRIT (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CRIT
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:355 HUNTERS MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:LORENA
Mailing Address - State:TX
Mailing Address - Zip Code:76655-3539
Mailing Address - Country:US
Mailing Address - Phone:254-644-4966
Mailing Address - Fax:254-732-0483
Practice Address - Street 1:355 HUNTERS MEADOW DR
Practice Address - Street 2:
Practice Address - City:LORENA
Practice Address - State:TX
Practice Address - Zip Code:76655-3539
Practice Address - Country:US
Practice Address - Phone:254-644-4966
Practice Address - Fax:254-732-0483
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2010-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4360207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF61037Medicare UPIN