Provider Demographics
NPI:1093021156
Name:WILLIAM F.M. DANIEL, M.D., F.A.C.S,
Entity Type:Organization
Organization Name:WILLIAM F.M. DANIEL, M.D., F.A.C.S,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FM
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-253-3147
Mailing Address - Street 1:1945 SCOTTSVILLE RD
Mailing Address - Street 2:STE B-2, PMB 354
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-3376
Mailing Address - Country:US
Mailing Address - Phone:270-253-3147
Mailing Address - Fax:270-253-3156
Practice Address - Street 1:1100 BROOKHAVEN RD
Practice Address - Street 2:SUITE 102
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-2746
Practice Address - Country:US
Practice Address - Phone:270-253-3147
Practice Address - Fax:270-253-3156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26280208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP1000023956Medicare UPIN