Provider Demographics
NPI:1134432875
Name:DARNELL, DAVID ALAN (DPH)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:DARNELL
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 SHADOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-8511
Mailing Address - Country:US
Mailing Address - Phone:731-664-3987
Mailing Address - Fax:
Practice Address - Street 1:277 SHADOW RIDGE DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-8511
Practice Address - Country:US
Practice Address - Phone:731-664-3987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC5341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist