Evans, Darrell Kennedy

Evans, Darrell Kennedy is an individual health care provider with primary practice located at 5871 Monclova Rd , Maumee OH 43537-1839. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Evans, Darrell Kennedy can be contacted via phone (419) 897-8376.

Contact Information

Primary practice address
5871 Monclova Rd Maumee OH 43537-1839
Phone: (419) 897-8376
Fax: (419) 887-8789
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 35044785 Ohio

Profile Details

NPI number 1013991702
LBN Legal business name Evans, Darrell Kennedy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated May 1st, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013991702 NPPES
Ohio MEDICAID 0439817
Ohio MEDICAID 0439814

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