| Doctor Name: | DR. DANIEL JOSEPH WILTZ |
| NPI Number: | 1184644254 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 023274 |
| Business Practice Address: | 1117 N Main St Suite B Saint Martinville, LA - 705823513 |
| Business Phone Number: | 3373947111 |
| Business Fax Number: | 3373948105 |
| Mailing Address: | 111 Coachman Dr, J YOUNGSVILLE |
| State: | LA |
| Postal Code: | 705925239 |
| Phone Number: | 3378390177 |
| Fax Number: | |
| NPI Enumeration Date: | 07/20/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 023274 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |