Provider Demographics
NPI:1851365191
Name:FEATHERSTON, DANIEL P (MD)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:P
Last Name:FEATHERSTON
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 1:2216 N 74TH WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-1542
Mailing Address - Country:US
Mailing Address - Phone:480-703-5064
Mailing Address - Fax:
Practice Address - Street 1:2216 N 74TH WAY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-1542
Practice Address - Country:US
Practice Address - Phone:480-703-5064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19933207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZM0155730OtherRAILROAD MEDICARE
AZ21094Medicare ID - Type Unspecified
AZC45161Medicare UPIN