Sumrok, Daniel David

Sumrok, Daniel David is an sole proprietor health care provider with primary practice located at 1894 Cedar St 1301 Primacy Parkway, Mc Kenzie TN 38201-2206. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Sumrok, Daniel David can be contacted via phone (731) 352-0603.

Contact Information

Primary practice address
1894 Cedar St 1301 Primacy Parkway Mc Kenzie TN 38201-2206
Phone: (731) 352-0603
Fax: (731) 352-0185
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X 21860 Tennessee
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD0000021860 Tennessee

Profile Details

NPI number 1669461679
LBN Legal business name Sumrok, Daniel David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2005
Last updated Mar 29th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669461679 NPPES
Arkansas MEDICAID 207113001
Arkansas MEDICAID 3063617
Arkansas MEDICAID 03488833

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