Healthcare Provider Details

I. General information

NPI: 1184247652
Provider Name (Legal Business Name): DANIEL PAUL O'TOOLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2529 GLENN HENDREN DR STE G80
LIBERTY MO
64068-9601
US

IV. Provider business mailing address

2529 GLENN HENDREN DR STE G80
LIBERTY MO
64068-9601
US

V. Phone/Fax

Practice location:
  • Phone: 816-415-7990
  • Fax: 816-781-7901
Mailing address:
  • Phone: 816-415-7990
  • Fax: 816-781-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number2026006161
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: