Provider Demographics
NPI:1144056110
Name:MAECHLER, DANIEL BRIAN
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:BRIAN
Last Name:MAECHLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:314-543-6979
Mailing Address - Fax:314-364-6321
Practice Address - Street 1:2100 N 62ND ST STE A
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72904-5163
Practice Address - Country:US
Practice Address - Phone:479-431-3700
Practice Address - Fax:479-431-3738
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR213992363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care