Healthcare Provider Details

I. General information

NPI: 1265464416
Provider Name (Legal Business Name): MICHAEL D DARNELL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 E MAIN ST SUITE D
PAYSON AZ
85541-5488
US

IV. Provider business mailing address

PO BOX 859
PAYSON AZ
85547-0859
US

V. Phone/Fax

Practice location:
  • Phone: 928-472-5260
  • Fax: 928-472-3444
Mailing address:
  • Phone: 928-472-5260
  • Fax: 928-472-3444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number005170
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: