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General NPI Number Information
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NPI Number | 1902978000
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Entity Type | Individual
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Provider Name | ROYLAN JAMES MCDANIEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 2401 S TUCKER AVE STE 4
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City | PITTSBURG
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State | KS
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Zip | 66762-6619
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Country | US
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Telephone | 620-231-2490
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Fax | 620-231-3920
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Provider Business Mailing Address
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Address Line | 2401 S TUCKER AVE STE 4
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City | PITTSBURG
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State | KS
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Zip | 66762-6619
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Country | US
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Telephone | 620-231-2490
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Fax | 620-231-3920
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 20755
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License Number State | KS
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