Provider Demographics
NPI:1811044217
Name:DARRELL L. DONLEY, M.D.
Entity Type:Organization
Organization Name:DARRELL L. DONLEY, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:L
Authorized Official - Last Name:DONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-627-3379
Mailing Address - Street 1:1135 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-1600
Mailing Address - Country:US
Mailing Address - Phone:724-627-3379
Mailing Address - Fax:724-627-5107
Practice Address - Street 1:1135 8TH ST
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-1600
Practice Address - Country:US
Practice Address - Phone:724-627-3379
Practice Address - Fax:724-627-5107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001694452Medicaid
1814531OtherBLUE CROSS SHIELD
PA001694452Medicaid
G61326Medicare UPIN
=========OtherFEIN