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Individual

BRENT JACKSON MCDANIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1985 E FREEDOM DR, NEWBERRY, IN 47449-7125
(270) 314-4401
Mailing address
309 HIGHWAY 361, CRANE, IN 47522-9731
(270) 314-4401

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
02004071A
IN
207L00000X
Anesthesiology Physician
05348
KY
208D00000X
General Practice Physician
Primary
02004071A
IN

Other

Enumeration date
06/15/2011
Last updated
10/05/2023
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