Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 2021024751 | MO |
NPI | 1013449024 |
---|---|
Provider Name | Daniel Patrick Dansdill |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65212-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2017 |
Last Update Date | 13/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200056646 | (05) | MO |