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General NPI Number Information
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NPI Number | 1821810821
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Entity Type | Individual
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Provider Name | MR. DANIEL PAUL MIDYETT SR.
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Gender | Male
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 9301 OXFORD PLACE DR
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City | BATON ROUGE
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State | LA
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Zip | 70809-2557
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Country | US
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Telephone | 318-423-6848
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Fax |
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Provider Business Mailing Address
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Address Line | 307 INTERNATIONAL CIR STE 100
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City | COCKEYSVILLE
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State | MD
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Zip | 21030-1387
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Country | US
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Telephone | 225-924-2851
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 00696
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License Number State | LA
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