Provider Demographics
NPI:1083609655
Name:NAUGHTON, DANIEL PAUL (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PAUL
Last Name:NAUGHTON
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:1837 LEBANON AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62221-2595
Mailing Address - Country:US
Mailing Address - Phone:618-256-7917
Mailing Address - Fax:618-256-7239
Practice Address - Street 1:310 W LOSEY ST
Practice Address - Street 2:
Practice Address - City:SCOTT AFB
Practice Address - State:IL
Practice Address - Zip Code:62225-5250
Practice Address - Country:US
Practice Address - Phone:618-256-7409
Practice Address - Fax:618-256-7239
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OTH000Medicare UPIN