Provider Demographics
NPI:1326011396
Name:DARKES, LEROY S (MD)
Entity Type:Individual
Prefix:
First Name:LEROY
Middle Name:S
Last Name:DARKES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 HEALTH PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-6933
Practice Address - Country:US
Practice Address - Phone:984-215-5030
Practice Address - Fax:984-215-5035
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38501207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCAD2925886OtherDEA
NC8927076Medicaid
NCNC11710DMedicare PIN
NC2158411AMedicare PIN
NCNC1170BMedicare PIN
C59182Medicare UPIN
NC27076OtherBLUE CROSS BLUE SHIELD
NC38501OtherNORTH CAROLINA MEDICAL BOARD LICENSE
NCNC1170AMedicare PIN