MEDICARE: DR. DANIEL THOMAS SANDLIN 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	208VP0014X	Interventional Pain Medicine Physician	82602	GA

General Provider Information

NPI Number	:	1770993792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL THOMAS SANDLIN M.D.

Provider Business Mailing Address
First Line	:	1015 LAFAYETTE PKWY STE 100
Second Line	:
City	:	LAGRANGE
State	:	GA
Zip	:	30241-3584
Country	:	US
Telephone Number	:	762-842-0221
Fax Number	:	762-323-1275

Provider Business Practice Location Address
First Line	:	1015 LAFAYETTE PKWY STE 100
Second Line	:
City	:	LAGRANGE
State	:	GA
Zip	:	30241-3584
Country	:	US
Telephone Number	:	762-842-0221
Fax Number	:	762-323-1275

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

Provider Enumeration Date	:	04/29/2014
Last Update Date	:	10/02/2024

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