Provider Demographics
NPI:1649093279
Name:DAWKINS, DARRYL EDWARD JR
Entity type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:EDWARD
Last Name:DAWKINS
Suffix:JR
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 1:916 E MCPHERSON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-3212
Mailing Address - Country:US
Mailing Address - Phone:833-323-8726
Mailing Address - Fax:
Practice Address - Street 1:916 E MCPHERSON ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-3212
Practice Address - Country:US
Practice Address - Phone:833-323-8726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver