Individual
DEREK DARNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
111 W STONE DR STE 110, KINGSPORT, TN 37660-6027
(423) 224-3701
(423) 224-3709
Mailing address
603 CAMPUS DR, SUITE 100, ABINGDON, VA 24210-9700
(276) 739-8010
(276) 628-1410
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003604
VA
363A00000X
Physician Assistant
1995
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1526508
—
TN
05
—
1700166188
—
VA
01
—
P01048892
RR MEDICARE
VA
Enumeration date
08/17/2011
Last updated
06/05/2018
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