Provider Demographics
NPI:1801992656
Name:MITCHELL, DONALD ROY (BS DC)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ROY
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:BS DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:901 PUERTO RICO AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-6447
Mailing Address - Country:US
Mailing Address - Phone:575-437-0350
Mailing Address - Fax:575-437-0352
Practice Address - Street 1:901 PUERTO RICO AVE
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310
Practice Address - Country:US
Practice Address - Phone:505-437-0350
Practice Address - Fax:505-437-0352
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM997111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T40978Medicare UPIN