Provider Demographics
NPI:1407972680
Name:JOACHIM, DAN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:WILLIAM
Last Name:JOACHIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 STARBRUSH CIR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7208
Mailing Address - Country:US
Mailing Address - Phone:985-871-6800
Mailing Address - Fax:866-845-8810
Practice Address - Street 1:76 STARBRUSH CIR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7208
Practice Address - Country:US
Practice Address - Phone:985-871-6800
Practice Address - Fax:866-845-8810
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0190702084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology