Individual
DR. DARYL WINSTON MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2508 BERT KOUNS LOOP, SUITE 401, SHREVEPORT, LA 71118-3133
(318) 686-5440
(318) 686-0624
Mailing address
2508 BERT KOUNS LOOP, SUITE 401, SHREVEPORT, LA 71118-3133
(318) 686-5440
(318) 686-0624
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
07044R
LA
207V00000X
Obstetrics & Gynecology Physician
Primary
MD.07044R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109244702
—
TX
05
—
1378071
—
LA
01
—
29416
BCBS OF LA
LA
01
—
8083TU
BCBS OF TX
TX
Enumeration date
01/05/2006
Last updated
06/18/2024
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