# DR. DALE THOMAS LANDRY JR.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1518108588
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | ME123092 | FL | Yes |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | ME 123092 | FL | — |

## Other

- **Enumeration date:** 03/20/2009
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 151CH | BCBS FL | FL |
| 01 | — | APPLYING ATN 598515 | FL MEDICAID | FL |
| 01 | — | ME123092 | MEDICAL LICENSE | FL |
| 01 | — | Z170402 | MEDICARE PTAN | — |