Provider Demographics
NPI:1407087224
Name:DANIEL D. SCHRADER, M.D. P.L.L.C.
Entity Type:Organization
Organization Name:DANIEL D. SCHRADER, M.D. P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHRADER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-864-6700
Mailing Address - Street 1:704 W GROVE ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-4416
Mailing Address - Country:US
Mailing Address - Phone:870-864-6700
Mailing Address - Fax:870-864-6704
Practice Address - Street 1:704 W GROVE ST
Practice Address - Street 2:SUITE 7
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4416
Practice Address - Country:US
Practice Address - Phone:870-864-6700
Practice Address - Fax:870-864-6704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3620207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty