| Doctor Name: | DANIEL SHANE BRILEY |
| NPI Number: | 1194966374 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA289AR |
| Business Practice Address: | 2125 E Main St Ste 10 Siloam Springs, AR - 727615576 |
| Business Phone Number: | 4795248552 |
| Business Fax Number: | 4795248593 |
| Mailing Address: | 2125 E Main St Ste 10, SILOAM SPRINGS |
| State: | AR |
| Postal Code: | 727615576 |
| Phone Number: | 4795248552 |
| Fax Number: | |
| NPI Enumeration Date: | 03/17/2009 |
| NPI Last Update Date: | 03/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA289AR |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |