Provider Demographics
NPI:1417082520
Name:DARNELL, JEFF C (MD)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:C
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 1:3829 EAST 126TH STREET
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-3151
Mailing Address - Country:US
Mailing Address - Phone:317-844-7060
Mailing Address - Fax:
Practice Address - Street 1:3829 EAST 126TH STREET
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-3151
Practice Address - Country:US
Practice Address - Phone:317-844-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01022989A207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B28169Medicare UPIN
IN715530CMedicare ID - Type Unspecified