Medlock, Daniel D

Medlock, Daniel D is an individual health care provider with primary practice located at 1320 Wisconsin Ave , Racine WI 53403-1978. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Medlock, Daniel D can be contacted via phone (262) 687-2956.

Contact Information

Primary practice address
1320 Wisconsin Ave Racine WI 53403-1978
Phone: (262) 687-2956
Fax: (262) 687-2014
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 9750 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 9750 Wisconsin

Profile Details

NPI number 1639439433
LBN Legal business name Medlock, Daniel D
Credentials APNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2012
Last updated Jan 24th, 2022 - about 4 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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