Provider Demographics
NPI:1588644223
Name:LALONDE, DANIEL R JR (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:R
Last Name:LALONDE
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 1:200 MEDICAL CENTER DR STE 3L
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9478
Mailing Address - Country:US
Mailing Address - Phone:606-487-7951
Mailing Address - Fax:606-487-7952
Practice Address - Street 1:200 MEDICAL CENTER DR STE 3L
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9478
Practice Address - Country:US
Practice Address - Phone:606-487-7951
Practice Address - Fax:606-487-7952
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0169482084P2900X
KY495792084P2900X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEG43737Medicare UPIN
KYK214100Medicare PIN