Provider Demographics
NPI:1356330732
Name:DARNELL, ZANE A (MD)
Entity Type:Individual
Prefix:
First Name:ZANE
Middle Name:A
Last Name:DARNELL
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:PO BOX 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-324-4745
Mailing Address - Fax:606-324-4941
Practice Address - Street 1:613 23RD ST
Practice Address - Street 2:STE 230
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2876
Practice Address - Country:US
Practice Address - Phone:606-324-4745
Practice Address - Fax:606-324-4941
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36725207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000196732OtherANTHEM BCBS
KY64037245Medicaid
WV001723552OtherMT STATE BCBS
WV0082178000Medicaid
OH2268111Medicaid
OH2268111Medicaid
KY64037245Medicaid
KY000000196732OtherANTHEM BCBS
060063622Medicare ID - Type UnspecifiedRR
KYP00652900Medicare PIN
KY00788015Medicare PIN
OH4214831Medicare PIN
KY0257211Medicare PIN