Healthcare Provider Details

I. General information

NPI: 1265136477
Provider Name (Legal Business Name): DARRIN LASWELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PARK ST
BOWLING GREEN KY
42101-1760
US

IV. Provider business mailing address

829 MCINTYRE ST
BOWLING GREEN KY
42101-6361
US

V. Phone/Fax

Practice location:
  • Phone: 270-745-1000
  • Fax:
Mailing address:
  • Phone: 502-598-6696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTP083
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: