Doctor Name: | MR. DARRICK MATTHEW MCDANALD |
NPI Number: | 1053366914 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 34959 |
Business Practice Address: | 1023 New Moody Ln Suite 103 La Grange, KY - 400319177 |
Business Phone Number: | 5022225558 |
Business Fax Number: | 5022223040 |
Mailing Address: | 1023 New Moody Ln, Suite 103 LA GRANGE |
State: | KY |
Postal Code: | 400319177 |
Phone Number: | 5022225558 |
Fax Number: | 5022223040 |
NPI Enumeration Date: | 05/22/2006 |
NPI Last Update Date: | 06/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 34959 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |