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General NPI Number Information
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NPI Number | 1770909954
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Entity Type | Individual
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Provider Name | DARYL MARCELL BEARD
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Gender | Male
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 04/17/2015
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Provider Practice Location Address
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Address Line | 11070 MEAD RD APT 0000
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City | BATON ROUGE
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State | LA
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Zip | 70816-2299
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Country | US
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Telephone | 225-445-4931
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Fax |
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Provider Business Mailing Address
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Address Line | 11528 OLD HAMMOND HWY
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City | BATON ROUGE
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State | LA
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Zip | 70816-8400
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Country | US
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Telephone | 123-456-7890
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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