Mcdaniel, Renny Theodore

Mcdaniel, Renny Theodore is an individual health care provider with primary practice located at 15 S 1000 E Ste 100 , Payson UT 84651-5592. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mcdaniel, Renny Theodore can be contacted via phone (801) 465-9480.

Contact Information

Primary practice address
15 S 1000 E Ste 100 Payson UT 84651-5592
Phone: (801) 465-9480
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Q4631 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 10738150-1205 Utah

Profile Details

NPI number 1013283449
LBN Legal business name Mcdaniel, Renny Theodore
Credentials M.D., M.P.H.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2012
Last updated Mar 21st, 2019 - about 7 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 1013283449 NPPES
Texas MEDICAID 348324001

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