Provider Demographics
NPI:1669438453
Name:CONWELL, DARWIN L (MD)
Entity type:Individual
Prefix:
First Name:DARWIN
Middle Name:L
Last Name:CONWELL
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 1:900 S LIMESTONE CTW 303
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-1559
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-1240
Practice Address - Country:US
Practice Address - Phone:859-323-0079
Practice Address - Fax:859-257-6868
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY56692207RG0100X
KYTP705207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0981353Medicaid
OHF84660Medicare UPIN