Provider Demographics
NPI:1487415006
Name:NEAL, DARNELL LAMAR
Entity type:Individual
Prefix:
First Name:DARNELL
Middle Name:LAMAR
Last Name:NEAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RONALD
Other - Middle Name:
Other - Last Name:BENEDICT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6809 FEYHURST DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3576
Mailing Address - Country:US
Mailing Address - Phone:502-295-1226
Mailing Address - Fax:
Practice Address - Street 1:6809 FEYHURST DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3576
Practice Address - Country:US
Practice Address - Phone:502-295-1226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor