Provider Demographics
NPI:1326072901
Name:DANIELS, ANTHONY E (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:E
Last Name:DANIELS
Suffix:
Gender:M
Credentials:MD
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 803929
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-3929
Mailing Address - Country:US
Mailing Address - Phone:800-953-0104
Mailing Address - Fax:
Practice Address - Street 1:112 W ROSS BLVD STE D
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-7220
Practice Address - Country:US
Practice Address - Phone:620-371-6900
Practice Address - Fax:620-371-6364
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4589174400000X
AZ49458207V00000X
KS04-49478207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR4134347OtherAETNA
AZ951351Medicaid
AR159506001Medicaid
AR3965227OtherCIGNA
AR06040013600OtherQUALCHOICE
AZ951351Medicaid
AZZ171568Medicare PIN
AR159506001Medicaid