Provider Demographics
NPI:1962470625
Name:RINEHART, DARREL R (MD)
Entity type:Individual
Prefix:
First Name:DARREL
Middle Name:R
Last Name:RINEHART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1116
Mailing Address - Country:US
Mailing Address - Phone:765-932-4111
Mailing Address - Fax:765-932-7062
Practice Address - Street 1:201 CONRAD HARCOURT WAY
Practice Address - Street 2:SUITE A
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-1116
Practice Address - Country:US
Practice Address - Phone:765-932-7591
Practice Address - Fax:765-932-7576
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15431207R00000X
IN01031165A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3007338Medicaid
TN3710089Medicaid
TN3007338Medicaid
TN3710089Medicare PIN