Provider Demographics
NPI:1013204999
Name:NEWKIRK, DARREL DEAN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DARREL
Middle Name:DEAN
Last Name:NEWKIRK
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5322 ROBERT RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1156
Mailing Address - Country:US
Mailing Address - Phone:304-759-9243
Mailing Address - Fax:
Practice Address - Street 1:5322 ROBERT RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25313-1156
Practice Address - Country:US
Practice Address - Phone:304-759-9243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3J112083P0901X
KS04-17311208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F54335Medicare UPIN