| Tara Mitchell, DO | |
| 608 New Hope Rd Ste 7, Princeton, WV 24740-2287 | |
| (304) 952-2087 | |
| Not Available | 
| Full Name | Tara Mitchell | 
|---|---|
| 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 | 
|---|---|
| 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 | 
|---|---|
| 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 |