Provider Demographics
NPI:1366480303
Name:QUIGLEY, DAYLE G (MD)
Entity Type:Individual
Prefix:DR
First Name:DAYLE
Middle Name:G
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3596
Mailing Address - Country:US
Mailing Address - Phone:320-632-5441
Mailing Address - Fax:320-631-5616
Practice Address - Street 1:815 2ND ST SE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3505
Practice Address - Country:US
Practice Address - Phone:320-632-5441
Practice Address - Fax:320-631-5616
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37917-020207Q00000X
MN66397207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32247100Medicaid