Healthcare Provider Details

I. General information

NPI: 1811104714
Provider Name (Legal Business Name): DANEIL STRICKLAND MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 S JEFFERSON AVE
WEST JEFFERSON NC
28694
US

IV. Provider business mailing address

PO BOX 70
WEST JEFFERSON NC
28694-0070
US

V. Phone/Fax

Practice location:
  • Phone: 336-846-6500
  • Fax: 336-846-7900
Mailing address:
  • Phone: 336-846-6500
  • Fax: 336-846-7900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DANIEL MICHAEL STRICKLAND
Title or Position: OWNER
Credential: MD
Phone: 336-846-6500