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NPI Code Detail

MEDICARE: DANIEL SURGICAL CARE INC

MEDICARE: DANIEL SURGICAL CARE INC
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
1208600000XSurgery Physician

General Provider Information

NPI Number : 1659913135
Entity Type Code : Organization
Provider Name (Legal Business Name) : DANIEL SURGICAL CARE INC
Provider Business Mailing Address
First Line : PO BOX 185
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73101-0185
Country : US
Telephone Number : 405-418-4800
Fax Number : 405-418-4820
Provider Business Practice Location Address
First Line : 4827 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-3835
Country : US
Telephone Number : 405-632-4252
Fax Number : 405-632-6166
Authorized Official
Title or Position : OWNER
Name : IAN DANIEL
Credential : MD
Telephone Number : 405-550-7083
Provider Enumeration Date : 10/16/2019
Last Update Date : 10/16/2019

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