Individual
DR. KELVIN PAUL MCDANIEL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6420 CLAYTON RD, DEPARTMENT OF INTERNAL MEDICINE, ST. LOUIS, MO 63117
(314) 768-8778
Mailing address
328 TWIN RIVER DR, COVINGTON, LA 70433-8504
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
390200000
MO
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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