Provider Demographics
NPI:1407986524
Name:FENTRESS, DARREN SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:SCOTT
Last Name:FENTRESS
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 1:1801 ASHLEY CIR
Mailing Address - Street 2:SUITE 535
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-3362
Mailing Address - Country:US
Mailing Address - Phone:270-790-5550
Mailing Address - Fax:270-793-5351
Practice Address - Street 1:1801 ASHLEY CIR
Practice Address - Street 2:SUITE 535
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3362
Practice Address - Country:US
Practice Address - Phone:270-790-5550
Practice Address - Fax:270-793-5351
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40850208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00418001Medicare PIN