Provider Demographics
NPI:1831432913
Name:OZINGA, DANIEL JAMES (PA-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:OZINGA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 CONNER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7112
Mailing Address - Country:US
Mailing Address - Phone:919-951-7600
Mailing Address - Fax:919-929-8474
Practice Address - Street 1:107 CONNER DR STE 100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7112
Practice Address - Country:US
Practice Address - Phone:919-951-7600
Practice Address - Fax:919-929-8474
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085005424363A00000X
NC0010-14752363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL385004043OtherCS LICENSE
IL1109788OtherSPECIALTY BOARDS
IL085005424OtherSTATE LICENSE
IL085005424OtherSTATE LICENSE