Individual
DANIEL S KANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2021 MERCY WAY STE 102, JEFFERSONVILLE, IN 47130-1307
(812) 218-4630
(812) 218-6431
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02002542A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000486161
ANTHEM- NORTON ICC
KY
01
—
00533030
MEDICARE- NORTON ICC
KY
01
—
02002542A
STATE LICENSE
IN
01
—
084514
SIHO- NORTON ICC
KY
05
—
200396790
—
IN
05
—
64068968
—
KY
01
—
P00408270
RAILROAD MEDICARE
IN
01
—
P00822031
RAILROAD MEDICARE- ICC
KY
Enumeration date
03/05/2007
Last updated
02/26/2024
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