Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 6998 | LA |
Y | 213EG0000X | General Practice | 6998 | LA |
NPI | 1003477043 |
---|---|
Provider Name | Daniel Adler JR. |
First Address | New Iberia, LA 70563-1704 |
Second Address | New Iberia, LA 70560-5727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2019 |
Last Update Date | 20/06/2019 |