Provider Demographics
NPI:1710720842
Name:MCPHERSON, DARRYL JR
Entity type:Individual
Prefix:
First Name:DARRYL
Middle Name:
Last Name:MCPHERSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4848 E 88TH ST
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2012
Mailing Address - Country:US
Mailing Address - Phone:216-356-8787
Mailing Address - Fax:
Practice Address - Street 1:4848 E 88TH ST
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2012
Practice Address - Country:US
Practice Address - Phone:216-356-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide