Healthcare Provider Details

I. General information

NPI: 1609816776
Provider Name (Legal Business Name): DANIEL STEVEN GAFFIN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6316 PICCADILLY SQUARE DR SUITE A
MOBILE AL
36609-5143
US

IV. Provider business mailing address

6316 PICCADILLY SQUARE DR SUITE A
MOBILE AL
36609-5143
US

V. Phone/Fax

Practice location:
  • Phone: 251-343-0010
  • Fax: 251-343-2202
Mailing address:
  • Phone: 251-343-0010
  • Fax: 251-343-2202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number114
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: