Provider Demographics
NPI:1306839535
Name:DARNELL, DONALD BART (OD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:BART
Last Name:DARNELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2393 SCHUST RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1334
Mailing Address - Country:US
Mailing Address - Phone:989-793-2820
Mailing Address - Fax:989-755-1463
Practice Address - Street 1:2393 SCHUST RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-1334
Practice Address - Country:US
Practice Address - Phone:989-793-2820
Practice Address - Fax:989-755-1463
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDD003811152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3484042Medicaid
38-2334055OtherTAX ID - GROUP
180G310710OtherBLUE CROSS BLUE SHIELD
38-2334055OtherTAX ID - GROUP
MI382334055OtherGROUP TAX ID
MIOC56509OtherBLUE CROSS VISION
MI3484042Medicaid
MIU63383Medicare UPIN
MI180037242OtherRAILROAD MEDICARE