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Individual

DR. DANIEL M TKACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2601 KENTUCKY AVE, STE 401, PADUCAH, KY 42003-3827
(270) 444-8200
(270) 444-8398
Mailing address
2601 KENTUCKY AVE, STE 401, PADUCAH, KY 42003-3827
(270) 444-8200
(270) 444-8398

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
30632
KY
2086S0105X
Surgery of the Hand (Surgery) Physician
30632
KY
2086S0122X
Plastic and Reconstructive Surgery Physician
30632
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000200472
BLUE CROSS
KY
01
164277500
US DEPT OF LABOR
01
240006752
RAILROAD MEDICARE
05
64306327
KY
Enumeration date
07/19/2006
Last updated
11/24/2010
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