Provider Demographics
NPI:1437157120
Name:DARNELL, JOHN HOWARD JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:HOWARD
Last Name:DARNELL
Suffix:JR
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 987
Mailing Address - Street 2:
Mailing Address - City:FLATWOODS
Mailing Address - State:KY
Mailing Address - Zip Code:41139-0987
Mailing Address - Country:US
Mailing Address - Phone:606-836-3196
Mailing Address - Fax:606-836-2564
Practice Address - Street 1:1101 SAINT CHRISTOPHER DR
Practice Address - Street 2:SUITE 250
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7087
Practice Address - Country:US
Practice Address - Phone:606-836-3196
Practice Address - Fax:606-836-2564
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21502207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000191986OtherBLUE CROSS BLUE SHIELD
OH0537646Medicaid
KY64215023Medicaid
080172359Medicare ID - Type UnspecifiedRAILROAD MEDICARE
C69081Medicare UPIN
KY0676505Medicare ID - Type UnspecifiedKY MEDICARE
OH0537646Medicaid
000000191986OtherBLUE CROSS BLUE SHIELD