Provider Demographics
NPI:1609075720
Name:DI IULIO, DARREN P (DPM)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:P
Last Name:DI IULIO
Suffix:
Gender:M
Credentials:DPM
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 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-212-0175
Mailing Address - Fax:859-441-3698
Practice Address - Street 1:525 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:KY
Practice Address - Zip Code:41071
Practice Address - Country:US
Practice Address - Phone:859-212-0175
Practice Address - Fax:859-441-3698
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3464213ES0103X
KY00326213ES0131X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000611804OtherANTHEM PIN
9944851OtherCIGNA PIN
9592120OtherAETNA PIN
1235152448OtherGRP NPI
KY80900004Medicaid
KY7100075840Medicaid
KY1467511162Medicare PIN
KY4111020001Medicare PIN
KY80900004Medicaid
000000611804OtherANTHEM PIN
KY7100075840Medicaid
KY1548545395Medicare NSC
KY8787Medicare PIN
KY6198Medicare PIN