Tara Mitchell, DO | |
608 New Hope Rd Ste 7, Princeton, WV 24740-2287 | |
(304) 952-2087 | |
Not Available |
Full Name | Tara Mitchell |
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Gender | Female |
Speciality | Pediatrics - Adolescent Medicine |
Location | 608 New Hope Rd Ste 7, Princeton, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326221888 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 2309 (West Virginia) | Secondary |
2080A0000X | Pediatrics - Adolescent Medicine | WV2309 (West Virginia) | Primary |
Entity Name | Lively Pediatrics Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063006047 PECOS PAC ID: 1557779741 Enrollment ID: O20210428002340 |
Mailing Address | Practice Location Address |
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Tara Mitchell, DO 608 New Hope Rd Ste 7, Princeton, WV 24740-2287 Ph: (304) 952-2087 | Tara Mitchell, DO 608 New Hope Rd Ste 7, Princeton, WV 24740-2287 Ph: (304) 952-2087 |
Dr. David Beihl, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 122 12th St, Princeton, WV 24740 Phone: 304-487-7000 | |
Inas Hassan Al-attar, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 34 New Hope Rd Ste 3, Princeton, WV 24740 Phone: 304-487-0415 Fax: 304-487-0417 | |
Dr. Amira I Khokar, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 608 New Hope Rd Ste 3, Princeton, WV 24740 Phone: 304-487-6065 Fax: 304-425-5420 | |
Ghazala Qureshi Khokar, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 608 New Hope Rd Ste 3, Princeton, WV 24740 Phone: 304-487-7530 Fax: 304-425-5420 |