Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD.300696 | LA |
NPI | 1003234915 |
---|---|
Provider Name | Daniel Naul |
First Address | Thibodaux, LA 70301-2922 |
Second Address | Baton Rouge, LA 70810-1907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2014 |
Last Update Date | 07/04/2016 |