MEDICARE: DANIEL JAMES BRICELAND M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	18851	AZ

General Provider Information

NPI Number	:	1154350817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL JAMES BRICELAND M.D.

Provider Business Mailing Address
First Line	:	13624 W CAMINO DEL SOL STE 200
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-3401
Country	:	US
Telephone Number	:	623-546-2020
Fax Number	:	623-546-2399

Provider Business Practice Location Address
First Line	:	13624 W CAMINO DEL SOL STE 200
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-3401
Country	:	US
Telephone Number	:	623-546-2020
Fax Number	:	623-546-2399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	10/09/2007

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