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General NPI Number Information
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NPI Number | 1326596354
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Entity Type | Individual
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Provider Name | DANIEL JOHN OATES III CRNP
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Gender | Male
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Dates
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Enumeration Date | 09/19/2016
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 108 MCMEANS AVE
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City | BAY MINETTE
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State | AL
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Zip | 36507-3130
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Country | US
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Telephone | 251-937-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 49920A DYAS RD
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City | BAY MINETTE
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State | AL
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Zip | 36507-7300
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Country | US
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Telephone | 251-753-6287
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-105085
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License Number State | AL
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