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General NPI Number Information
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NPI Number | 1275323511
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Entity Type | Individual
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Provider Name | GEORGE DANIEL MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 905C S FRONTAGE RD
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City | MERIDIAN
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State | MS
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Zip | 39301-6113
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Country | US
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Telephone | 601-482-4955
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Fax |
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Provider Business Mailing Address
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Address Line | 9457 BAY COLONY DR APT 2S
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City | DES PLAINES
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State | IL
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Zip | 60016-3613
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Country | US
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Telephone | 773-656-7365
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Fax |
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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 | DANI-1GP4S3
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License Number State | MS
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