Provider Demographics
NPI:1831262286
Name:DARR, JOSEPH A (DC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:DARR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 EAST THIRD ST
Mailing Address - Street 2:
Mailing Address - City:PORT CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:43452-1126
Mailing Address - Country:US
Mailing Address - Phone:419-734-4210
Mailing Address - Fax:419-732-2656
Practice Address - Street 1:125 EAST THIRD ST
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452-1126
Practice Address - Country:US
Practice Address - Phone:419-734-4210
Practice Address - Fax:419-732-2656
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
115431OtherAETNA
OH6391795Medicaid
T47097Medicare UPIN
OH6391795Medicaid