Healthcare Provider Details

I. General information

NPI: 1962470625
Provider Name (Legal Business Name): DARREL R. RINEHART MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CONRAD HARCOURT WAY SUITE A
RUSHVILLE IN
46173-1116
US

IV. Provider business mailing address

1300 N MAIN ST
RUSHVILLE IN
46173-1116
US

V. Phone/Fax

Practice location:
  • Phone: 765-932-7591
  • Fax: 765-932-7576
Mailing address:
  • Phone: 765-932-4111
  • Fax: 765-932-7062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number15431
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01031165A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: