Provider Demographics
NPI:1790737690
Name:LARKE, DARYL SHELDON (MD)
Entity Type:Individual
Prefix:DR
First Name:DARYL
Middle Name:SHELDON
Last Name:LARKE
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:PO BOX 406
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-0406
Mailing Address - Country:US
Mailing Address - Phone:606-889-6200
Mailing Address - Fax:606-889-6201
Practice Address - Street 1:5000 KY ROUTE 321
Practice Address - Street 2:SUITE 2129
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9113
Practice Address - Country:US
Practice Address - Phone:606-889-6200
Practice Address - Fax:606-889-6201
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101239676207X00000X
KY42968207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64414691Medicaid
KY64414691Medicaid
KY1565639Medicare PIN