MEDICARE: DANIEL LOUIS LONEY D.O.

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	207Q00000X	Family Medicine Physician	02001104A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205879285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL LOUIS LONEY D.O.

Provider Business Mailing Address
First Line	:	1540 PROVIDENT DR
Second Line	:
City	:	WARSAW
State	:	IN
Zip	:	46580-3291
Country	:	US
Telephone Number	:	574-372-5868
Fax Number	:	574-372-5869

Provider Business Practice Location Address
First Line	:	1540 PROVIDENT DR
Second Line	:
City	:	WARSAW
State	:	IN
Zip	:	46580-3291
Country	:	US
Telephone Number	:	574-372-5868
Fax Number	:	574-372-5869

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	10/05/2020

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