Provider Demographics
NPI:1306805379
Name:PROFFITT, DANNY L (MD)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:L
Last Name:PROFFITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1060
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:AR
Mailing Address - Zip Code:72650-1060
Mailing Address - Country:US
Mailing Address - Phone:870-448-5101
Mailing Address - Fax:870-448-3767
Practice Address - Street 1:934 NORTH GASKILL
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72740-1319
Practice Address - Country:US
Practice Address - Phone:479-738-5500
Practice Address - Fax:479-738-1350
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC-5443207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR56362OtherBCBS
AR1160868OtherFIRST HEALTH
AR5046OtherCIGNA
AR13800000001OtherQUAL CHOICE
AR106373001Medicaid
AR120653OtherUNITED HEALTH CARE
AR80118147OtherRR MCR
AR5758420OtherAETNA
AR341358OtherHEALTH LINK
AR13800000001OtherQUAL CHOICE
AR56362OtherBCBS