Provider Demographics
NPI:1720141021
Name:CANALE, DANIEL DOYLE JR (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:DOYLE
Last Name:CANALE
Suffix:JR
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 1:1602 HATCHER LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4827
Mailing Address - Country:US
Mailing Address - Phone:931-388-0777
Mailing Address - Fax:931-388-1548
Practice Address - Street 1:1602 HATCHER LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4827
Practice Address - Country:US
Practice Address - Phone:931-388-0777
Practice Address - Fax:931-388-1548
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11903207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3040714OtherMC NON HOSPITAL
TN3040715Medicaid
3030971OtherBCBS
TN3040715Medicaid
TN3040715Medicare ID - Type Unspecified