Basic Information
| Provider Information | |||||||||
| NPI: | 1083683189 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAIGLE | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7901 EMERALD DR STE 7 | ||||||||
| Address2: | |||||||||
| City: | EMERALD ISLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285942880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2523546500 | ||||||||
| FaxNumber: | 2523545060 | ||||||||
| Practice Location | |||||||||
| Address1: | 7901 EMERALD DR STE 7 | ||||||||
| Address2: | |||||||||
| City: | EMERALD ISLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285942880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2523546500 | ||||||||
| FaxNumber: | 2523545060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 12/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | ME0074905 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | L017247 | LA | N | Allopathic & Osteopathic Physicians | Pediatrics | 207Q00000X | 2016-01350 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.