Provider Demographics
NPI:1053817916
Name:HARPER, DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:HARPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:DANIEL
Other - Middle Name:
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17936 KANTISHNA DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-8230
Mailing Address - Country:US
Mailing Address - Phone:337-546-5800
Mailing Address - Fax:
Practice Address - Street 1:3704 NORTH BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3658
Practice Address - Country:US
Practice Address - Phone:318-442-8399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-31
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD615816482085R0202X, 2085R0204X
LA3308412085R0202X
ARE-132362085R0202X
AK2215682085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology