Basic Information
| Provider Information | |||||||||
| NPI: | 1518018738 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YACONO | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2511 OLD CORNWALLIS RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277131869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199325700 | ||||||||
| FaxNumber: | 9199336881 | ||||||||
| Practice Location | |||||||||
| Address1: | 803 N JEFFERSON ST STE C | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2293125800 | ||||||||
| FaxNumber: | 2293125853 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2007 | ||||||||
| LastUpdateDate: | 06/11/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QG0300X | 058836 | GA | N | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | 207Q00000X | 30528 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.