Provider Demographics
NPI:1609816776
Name:GAFFIN, DANIEL STEVEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STEVEN
Last Name:GAFFIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6316 PICCADILLY SQUARE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-5143
Mailing Address - Country:US
Mailing Address - Phone:251-343-0010
Mailing Address - Fax:251-343-2202
Practice Address - Street 1:6316 PICCADILLY SQUARE DR
Practice Address - Street 2:SUITE A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5143
Practice Address - Country:US
Practice Address - Phone:251-343-0010
Practice Address - Fax:251-343-2202
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL114213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0545050002OtherDME MEDICARE
AL0545050002OtherDME MEDICARE
T68881Medicare UPIN
AL71281Medicare ID - Type Unspecified
AL73407Medicare ID - Type Unspecified