Provider Demographics
NPI:1427748839
Name:DANIELS, RONALD LEE JR
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:LEE
Last Name:DANIELS
Suffix:JR
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 1:1447 W WRANGLER BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:OK
Mailing Address - Zip Code:74868-2076
Mailing Address - Country:US
Mailing Address - Phone:405-303-8038
Mailing Address - Fax:
Practice Address - Street 1:1447 W WRANGLER BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:OK
Practice Address - Zip Code:74868-2076
Practice Address - Country:US
Practice Address - Phone:405-303-8038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist