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General NPI Number Information
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NPI Number | 1043264393
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Entity Type | Individual
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Provider Name | TYRONE L DANIELS MD
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Gender | Male
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 8019 DIXIE HWY STE 101
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City | LOUISVILLE
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State | KY
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Zip | 40258-1303
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Country | US
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Telephone | 502-333-3121
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Fax | 502-531-9538
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Provider Business Mailing Address
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Address Line | 8019 DIXIE HWY STE 101
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City | LOUISVILLE
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State | KY
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Zip | 40258-1303
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Country | US
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Telephone | 502-333-3121
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Fax | 502-531-9538
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 14818
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 32841
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License Number State | KY
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