Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 56034 | TN |
N | 207P00000X | Emergency Physician | ME61517 | FL |
N | 207Q00000X | Family Doctor | 13573 | SC |
N | 207Q00000X | Family Doctor | 27686 | AL |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 0101246311 | VA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 61517 | FL |
NPI | 1780692079 |
---|---|
Provider Name | Andrew P Daigle |
First Address | Jacksonville, FL 32257-2425 |
Second Address | Jacksonville, FL 32257-2425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 15/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
135730 | (05) | SC |
203013 | MEDCOST (01) | SC |
5908498 | (05) | NC |
7227499 | AETNA (01) | SC |
B92575 | (02) | SC |
C06778 | GROUP PTAN (01) | VA |