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General NPI Number Information
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NPI Number | 1205965563
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Entity Type | Individual
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Provider Name | DANIEL S KANTZ D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 2021 MERCY WAY STE 102
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-1307
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Country | US
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Telephone | 812-218-4630
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Fax | 812-218-6431
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02002542A
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License Number State | IN
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