Provider Demographics
NPI:1467758045
Name:FOSS, DANIEL P (RCS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:P
Last Name:FOSS
Suffix:
Gender:M
Credentials:RCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 W EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5924
Mailing Address - Country:US
Mailing Address - Phone:870-476-3727
Mailing Address - Fax:
Practice Address - Street 1:716 W EMERSON ST
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-5924
Practice Address - Country:US
Practice Address - Phone:870-476-3727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00076193246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography