Provider Demographics
NPI:1487705430
Name:DARNALL, JEFFREY T (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:T
Last Name:DARNALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 BARTOL AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-2214
Mailing Address - Country:US
Mailing Address - Phone:610-521-3202
Mailing Address - Fax:610-497-7937
Practice Address - Street 1:1 BARTOL AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078-2214
Practice Address - Country:US
Practice Address - Phone:610-521-3022
Practice Address - Fax:610-521-5715
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD019879E207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000901016Medicaid
PA93995Medicare PIN
PA000901016Medicaid