Provider Demographics
NPI:1033799879
Name:DARLING, DAMON CHARLES
Entity Type:Individual
Prefix:
First Name:DAMON
Middle Name:CHARLES
Last Name:DARLING
Suffix:
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 1:348 POE AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-1042
Mailing Address - Country:US
Mailing Address - Phone:619-376-8566
Mailing Address - Fax:
Practice Address - Street 1:348 POE AVE
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-1042
Practice Address - Country:US
Practice Address - Phone:619-376-8566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSQ211961175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist