Organization
DAVID R MCDANIEL OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID RONALD MCDANIEL OD (PRESIDENT/CEO)
(704) 739-1394
Entity
Organization
Contact information
Practice address
510 W KING ST, KINGS MTN, NC 28086-3310
(704) 739-1394
Mailing address
510 W KING ST, PO BOX 1127, KINGS MTN, NC 28086-3310
(704) 739-1394
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NC0991
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
246348
MEDICARE PTAN
NC
05
—
8909569
—
NC
Enumeration date
03/05/2012
Last updated
03/08/2012
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