Provider Demographics
NPI:1205313822
Name:GASKINS, DARNELL L
Entity type:Individual
Prefix:
First Name:DARNELL
Middle Name:L
Last Name:GASKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 COBBLEFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7675
Mailing Address - Country:US
Mailing Address - Phone:678-772-6357
Mailing Address - Fax:678-828-5675
Practice Address - Street 1:1511 COBBLEFIELD CIR
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-7675
Practice Address - Country:US
Practice Address - Phone:678-772-6357
Practice Address - Fax:678-828-5675
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
GA2023193306343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)