Provider Demographics
NPI:1811020696
Name:EDWARDS, DARWIN KEITH (MD)
Entity Type:Individual
Prefix:MR
First Name:DARWIN
Middle Name:KEITH
Last Name:EDWARDS
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 1:221 S PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1223
Mailing Address - Country:US
Mailing Address - Phone:502-589-1980
Mailing Address - Fax:502-589-1982
Practice Address - Street 1:221 S PRESTON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1223
Practice Address - Country:US
Practice Address - Phone:502-589-1980
Practice Address - Fax:502-589-1982
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18790207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1130651OtherINDIVIDUAL AND GROUP
KY000000061816OtherGROUP
KY2433239000OtherINDIVIDUAL
KY37000130Medicaid
KY000000054003OtherINDIVIDUAL
KY000000062006OtherINDIVIDUAL AND GROUP
KY2433194000OtherGROUP
KY2433194000OtherGROUP
KY4015101Medicare PIN