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Individual

TYRONE L DANIELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8019 DIXIE HWY STE 101, LOUISVILLE, KY 40258-1303
(502) 333-3121
(502) 531-9538
Mailing address
8019 DIXIE HWY STE 101, LOUISVILLE, KY 40258-1303
(502) 333-3121
(502) 531-9538

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
14818
WV
207RC0000X
Cardiovascular Disease Physician
Primary
32841
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0070798000
WV
05
64328412
KY
01
P00837112
MEDICARE RAILROAD
Enumeration date
05/20/2006
Last updated
09/11/2023
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