Provider Demographics
NPI:1710090709
Name:SANCHEZ, DANIEL J (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:SANCHEZ
Suffix:
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 1:1210 N. WASHINGTON,
Mailing Address - Street 2:CLINIC B, P.O. BOX 407
Mailing Address - City:PLAINVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67663-2505
Mailing Address - Country:US
Mailing Address - Phone:785-434-2622
Mailing Address - Fax:785-434-2577
Practice Address - Street 1:1210 N. WASHINGTON,
Practice Address - Street 2:CLINIC B
Practice Address - City:PLAINVILLE
Practice Address - State:KS
Practice Address - Zip Code:67663-1632
Practice Address - Country:US
Practice Address - Phone:785-434-2622
Practice Address - Fax:785-434-2577
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-24739207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0399OtherBC/BS RURAL HEALTH GROUP
KS623170OtherFIRSTGUARD PROVIDER #
KS110809OtherBC/BS GROUP
KS100427890AMedicaid
KS100427890BMedicaid
KS102317OtherBC/BS REG INDIVIDUAL
KS100146370BMedicaid
KS100146370BMedicaid
KS0399OtherBC/BS RURAL HEALTH GROUP
KS178968Medicare ID - Type UnspecifiedRURAL HEALTH MEDICARE
KS100427890AMedicaid