Healthcare Provider Details

I. General information

NPI: 1124235700
Provider Name (Legal Business Name): EDWARD A DARNEL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2622 W 28TH AVE
PINE BLUFF AR
71603-4917
US

IV. Provider business mailing address

4100 OLD WARREN RD APT 9
PINE BLUFF AR
71603-6113
US

V. Phone/Fax

Practice location:
  • Phone: 870-534-8991
  • Fax: 870-534-1076
Mailing address:
  • Phone: 870-534-8991
  • Fax: 870-534-1076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number1630
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: