Provider Demographics
NPI:1760369474
Name:AYLWARD, DARROCH (MD)
Entity type:Individual
Prefix:
First Name:DARROCH
Middle Name:
Last Name:AYLWARD
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:#207, 10134- 97 AVE
Mailing Address - Street 2:
Mailing Address - City:GRANDE PRAIRIE
Mailing Address - State:AB
Mailing Address - Zip Code:T8V7X6
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:#207, 10134- 97 AVE
Practice Address - Street 2:
Practice Address - City:GRANDE PRAIRIE
Practice Address - State:AB
Practice Address - Zip Code:T8V7X6
Practice Address - Country:CA
Practice Address - Phone:780-882-7797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00032403207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine