Basic Information
| Provider Information | |||||||||
| NPI: | 1265768832 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MITCHELL | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 PLAZA DR | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | BELLE VERNON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150124019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243795860 | ||||||||
| FaxNumber: | 7243795874 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 PLAZA DR | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | BELLE VERNON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150124019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243795860 | ||||||||
| FaxNumber: | 7243795874 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2009 | ||||||||
| LastUpdateDate: | 09/01/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X | 2010015947 | MO | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
No ID Information.