Provider Demographics
NPI:1588725733
Name:DARCEY, KEVIN WARREN (OD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:WARREN
Last Name:DARCEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MILFORD ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6952
Mailing Address - Country:US
Mailing Address - Phone:410-749-9290
Mailing Address - Fax:410-543-9087
Practice Address - Street 1:101 MILFORD ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6952
Practice Address - Country:US
Practice Address - Phone:410-749-9290
Practice Address - Fax:410-543-9087
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0937152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000619222Medicaid
MD226348300Medicaid
2133361OtherMAMSI
H788PE 534269OtherCAREFIRST BCBS
MDT6990001OtherCAREFIRST BLUE CHOICE
V02923Medicare UPIN
DE0000619222Medicaid
H788PE 534269OtherCAREFIRST BCBS