Provider Demographics
NPI:1538336946
Name:DO, DANIEL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:DO
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 1:800 ROSE ST
Mailing Address - Street 2:DEPARTMENT OF RADIOLOGY
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-323-5066
Mailing Address - Fax:859-257-4457
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:859-323-5069
Practice Address - Fax:859-257-4457
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY471092085R0204X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY11686Medicaid
LA11686Medicaid