Provider Demographics
NPI:1508869496
Name:DANIELS, GEORGE F JR (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:F
Last Name:DANIELS
Suffix:JR
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:PO BOX 1549
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16003-1549
Mailing Address - Country:US
Mailing Address - Phone:724-482-4257
Mailing Address - Fax:724-482-4785
Practice Address - Street 1:104 TECHNOLOGY DRIVE
Practice Address - Street 2:SUITE 204
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1801
Practice Address - Country:US
Practice Address - Phone:724-482-4257
Practice Address - Fax:724-482-4785
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD049939L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00111500OtherRR MEDICARE
PA0014934630004Medicaid
PA0014934630004Medicaid
P00111500OtherRR MEDICARE