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NPI Code Detail

MEDICARE: JOHN MARK MCDANIEL MD

MEDICARE: JOHN MARK MCDANIEL MD
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
1207Q00000XFamily Medicine Physician01029506IN

Other Identifiers

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

General Provider Information

NPI Number : 1932294204
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MARK MCDANIEL MD
Provider Business Mailing Address
First Line : 10649 BENNETT PKWY
Second Line :
City : ZIONSVILLE
State : IN
Zip : 46077-7849
Country : US
Telephone Number : 317-873-6700
Fax Number : 317-873-8200
Provider Business Practice Location Address
First Line : 10649 BENNETT PKWY
Second Line :
City : ZIONSVILLE
State : IN
Zip : 46077-7849
Country : US
Telephone Number : 317-873-6700
Fax Number : 317-873-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 03/24/2021

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