IndividualActive
Darrel Sides, CSA
NPI 1114079878 · Surgical Physician Assistant · Independence, KY
Provider details
- NPI number
- 1114079878
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CSA
- Sex
- Male
- Sole proprietor
- No
- License
- SA109 (KY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
6271 Martys Trail
Independence, KY 41051-0583
Phone: (859) 816-6684
Fax: (859) 356-0682
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 583
Independence, KY 41051-0583
Registry dates
- Enumerated
- 2007-01-16
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.