Individual
DANIEL P DARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2080 S FRONTAGE RD, SUITE 113, VICKSBURG, MS 39180-5328
(601) 636-1219
(601) 636-1076
Mailing address
PO BOX 321359, FLOWOOD, MS 39232-1359
(601) 936-1395
(601) 636-1076
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
08622
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019377
—
MS
05
—
1173622
—
LA
01
—
4357636
AETNA
MS
Enumeration date
06/30/2006
Last updated
08/24/2020
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