MEDICARE: DR. GABRIEL JAMES MITCHELL DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	340437	LA

General Provider Information

NPI Number	:	1871177105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GABRIEL JAMES MITCHELL DPM

Provider Business Mailing Address
First Line	:	592 UNADILLA ST
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-1240
Country	:	US
Telephone Number	:	318-519-7555
Fax Number	:

Provider Business Practice Location Address
First Line	:	592 UNADILLA ST
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-1240
Country	:	US
Telephone Number	:	318-519-7555
Fax Number	:	318-627-5999

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2021
Last Update Date	:	03/19/2026

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