Provider Demographics
NPI:1669454187
Name:GIFT, DANIEL K (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:K
Last Name:GIFT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-1215
Mailing Address - Country:US
Mailing Address - Phone:570-837-0112
Mailing Address - Fax:
Practice Address - Street 1:423 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:PA
Practice Address - Zip Code:17842-1215
Practice Address - Country:US
Practice Address - Phone:570-837-0112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE004310T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA391434OtherNATIONAL VISION ADMIN
PA13601OtherSPECTERA
PAGI287846OtherBLUE SHIELD
PA30085OtherDAVIS VISION
PA4310OtherVISION BENEFITS OF AMERIC
PAPA 4310OtherEYEMED
PAGI287846Medicare ID - Type Unspecified
PA30085OtherDAVIS VISION