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Individual

CHRISTOPHER LADALE DANIELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
116 MIMOSA DR, THOMASVILLE, GA 31792-6605
(229) 551-0083
Mailing address
900 CAIRO RD, THOMASVILLE, GA 31792-4255
(229) 227-5102

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
201390
LA
207RI0011X
Interventional Cardiology Physician
Primary
071484
GA
207RI0011X
Interventional Cardiology Physician
ME120935
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1073946
LA
Enumeration date
05/18/2007
Last updated
06/24/2021
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