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NPI Code Detail

MEDICARE: MR. DANIEL PAUL MIDYETT SR.

MEDICARE: MR. DANIEL PAUL MIDYETT SR.
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
1225100000XPhysical Therapist00696LA

General Provider Information

NPI Number : 1821810821
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL PAUL MIDYETT SR.
Provider Business Mailing Address
First Line : 307 INTERNATIONAL CIR STE 100
Second Line :
City : COCKEYSVILLE
State : MD
Zip : 21030-1387
Country : US
Telephone Number : 225-924-2851
Fax Number :
Provider Business Practice Location Address
First Line : 9301 OXFORD PLACE DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-2557
Country : US
Telephone Number : 318-423-6848
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2024
Last Update Date : 10/30/2024

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