Healthcare Provider Details

I. General information

NPI: 1205222940
Provider Name (Legal Business Name): DANIEL JACOB MARGUL MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 08/02/2025
Certification Date: 08/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 DUTCHMANS PKWY STE 170
LOUISVILLE KY
40205-3353
US

IV. Provider business mailing address

6420 DUTCHMANS PKWY STE 170
LOUISVILLE KY
40205-3353
US

V. Phone/Fax

Practice location:
  • Phone: 502-561-7220
  • Fax:
Mailing address:
  • Phone: 502-561-7220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35.144970
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberTP576
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: