Cornelius, Darrell R.

Cornelius, Darrell R. is an individual health care provider with primary practice located at 1311 E. Division Street , Mount Vernon WA 98274. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Cornelius, Darrell R. can be contacted via phone (360) 424-7991.

Contact Information

Primary practice address
1311 E. Division Street Mount Vernon WA 98274
Phone: (360) 424-7991
Fax: (360) 428-4377
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD00018397 Washington
Allopathic & Osteopathic Physicians / Urology 208800000X MD2086 Alaska

Profile Details

NPI number 1639270812
LBN Legal business name Cornelius, Darrell R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Sep 20th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639270812 NPPES
Washington MEDICAID 1646405
Washington MEDICAID MD2086

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