Provider Demographics
NPI:1780939462
Name:PERSINGER, DANIEL CALEB (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:CALEB
Last Name:PERSINGER
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 1:100 W MCCREIGHT AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1890
Mailing Address - Country:US
Mailing Address - Phone:937-717-4884
Mailing Address - Fax:937-717-6207
Practice Address - Street 1:100 W MCCREIGHT AVE STE 110
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1890
Practice Address - Country:US
Practice Address - Phone:937-717-4884
Practice Address - Fax:937-717-6207
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND14671208600000X
OH35.138203208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery