Individual provider · Type 1 NPI
Darrel Sides, CSA
Surgical Physician Assistant · Independence, KY
NPI number
1114079878
Active
Practice location
6271 Martys Trail
Independence, KY 41051-0583
Fax (859) 356-0682
Mailing address
PO Box 583
Independence, KY 41051-0583
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | SA109 (KY) |
Surgical Physician Assistant: Definition to come...
About NPI 1114079878
Darrel Sides, CSA's National Provider Identifier is 1114079878, issued on Jan 16, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Independence, KY. The record was last updated on Jul 8, 2007.