Provider Demographics
NPI:1417096132
Name:GARNER, DANIEL CRESTON (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CRESTON
Last Name:GARNER
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 1:3037 ST. JOHNS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129
Mailing Address - Country:US
Mailing Address - Phone:615-907-2313
Mailing Address - Fax:615-768-2856
Practice Address - Street 1:300 STONECREST BLVD
Practice Address - Street 2:STE 155
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5688
Practice Address - Country:US
Practice Address - Phone:615-768-2855
Practice Address - Fax:615-768-2856
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN371142085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4060258OtherBLUE CROSS BLUE SHIELD
H80053Medicare UPIN
3715295Medicare ID - Type Unspecified