Provider Demographics
NPI:1033297403
Name:MCDARBY, JAMES VINNIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:VINNIE
Last Name:MCDARBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:415 CHALAN SAN ANTONIO
Mailing Address - Street 2:SUITE 214
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913
Mailing Address - Country:US
Mailing Address - Phone:671-647-5381
Mailing Address - Fax:671-647-5385
Practice Address - Street 1:415 CHALAN SAN ANTONIO
Practice Address - Street 2:SUITE 214 ISLAND EYE CENTER
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-647-5381
Practice Address - Fax:671-647-5385
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUM000896207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F88470Medicare UPIN
50870Medicare ID - Type Unspecified