Mr Darrel Sides, CSA is a
Physician Assistant - Surgical based in Independence, Kentucky. Mr Darrel Sides is licensed to practice in Kentucky (license number SA109) and his current practice location is
6271 Martys Trail, Independence, Kentucky. He can be reached at his office (for appointments etc.) via phone at
(859) 816-6684.
NPI number for Mr Darrel Sides is 1114079878 and his current mailing address is Po Box 583, Independence, Kentucky. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1114079878.
Provider's Profile
| Full Name | Mr Darrel Sides |
|---|
| Gender | Male |
|---|
| Speciality | Physician Assistant - Surgical |
|---|
| Location | 6271 Martys Trail, Independence, Kentucky |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1114079878
- Provider Enumeration Date: 01/16/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Darrel Sides such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114079878 | NPI | - | NPPES |
| 000000308821 | Other | KY | BC |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AS0400X | Physician Assistant - Surgical | SA109 (Kentucky) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Darrel Sides is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Darrel Sides, CSA
Po Box 583,
Independence, KY 41051-0583
Ph: (859) 816-6684 | Mr Darrel Sides, CSA
6271 Martys Trail,
Independence, KY 41051-0583
Ph: (859) 816-6684 |
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