Provider Demographics
NPI:1053572438
Name:MITCHELL, CAROLYN GRAEBER (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:GRAEBER
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:PAGE
Other - Last Name:GRAEBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2121 E HARMONY RD UNIT 350
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3404
Mailing Address - Country:US
Mailing Address - Phone:970-214-8175
Mailing Address - Fax:
Practice Address - Street 1:2121 E HARMONY RD UNIT 350
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3404
Practice Address - Country:US
Practice Address - Phone:970-214-8175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA250330207W00000X
NY255515207W00000X
CODR.0066637207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology