Provider Demographics
NPI:1700851409
Name:NOBLE, DANIEL P (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:NOBLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3655 CROSSINGS DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7101
Mailing Address - Country:US
Mailing Address - Phone:928-778-9250
Mailing Address - Fax:844-713-8105
Practice Address - Street 1:3655 CROSSINGS DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7101
Practice Address - Country:US
Practice Address - Phone:928-778-9250
Practice Address - Fax:928-778-9309
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20097207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026133000Medicaid
AZZ181627Medicare PIN
A72589Medicare UPIN
NE273780Medicare PIN
NE10026133000Medicaid
NE35050OtherBCBS OF NEBRASKA
NE91177983268510A012OtherTRI CARE
KS2087286102Medicaid