Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 00335 | KY |
NPI | 1083874788 |
---|---|
Provider Name | Dr. Jerod Preston Darnell |
First Address | Ashland, KY 41101-2776 |
Second Address | Ashland, KY 41101-2776 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 22/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00659814 | RAILROAD (01) | KY |