Healthcare Provider Details
I. General information
NPI: 1366066516
Provider Name (Legal Business Name): GABRIEL DANIEL SEXTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/03/2020
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 W 11TH ST IU HEALTH PATHOLOGY LABORATORY, RM 4000H-2
INDIANAPOLIS IN
46202
US
IV. Provider business mailing address
350 W 11TH ST
INDIANAPOLIS IN
46202-4108
US
V. Phone/Fax
- Phone: 317-278-0844
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | 01100217A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: