Provider Demographics
NPI:1811104714
Name:DANEIL STRICKLAND MD
Entity type:Organization
Organization Name:DANEIL STRICKLAND MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-846-6500
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694-0070
Mailing Address - Country:US
Mailing Address - Phone:336-846-6500
Mailing Address - Fax:336-846-7900
Practice Address - Street 1:405 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:WEST JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28694
Practice Address - Country:US
Practice Address - Phone:336-846-6500
Practice Address - Fax:336-846-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1215009758OtherCATHY CLARK-NPI NUMBER
NC193189OtherCATHY CLARK MEDCOST #
NC7003870Medicaid
NC1992703607OtherDANIEL STRICKLAND-NPI NUM
NC891098UMedicaid
NC5906466Medicaid
NC1215009758OtherCATHY CLARK-NPI NUMBER
NCC22358Medicare UPIN