Individual
DANIEL E EGGLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
38339 S GRANITE CREST, TUCSON, AZ 85739
(313) 530-6692
Mailing address
38339 S GRANITE CREST, TUCSON, AZ 85739
(313) 530-6692
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
46562
AZ
2085R0202X
Diagnostic Radiology Physician
Primary
46562
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005472
GROUP MEDICAID ID
AZ
01
—
1750318036
PHYSICIAN INDIVIDUAL NPI
AZ
01
—
1841261989
GROUP NPI
AZ
05
—
769433
—
AZ
01
—
CS7943
GROUP MEDICARE RAILROAD ID & PTAN
AZ
01
—
Z93002
PHYSICIAN INDIVIDUAL MEDICARE ID #
AZ
01
—
ZWCBBM
GROUP MEDICARE ID
AZ
Enumeration date
06/26/2006
Last updated
12/30/2015
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