Provider Demographics
NPI:1245620244
Name:TOTTEN MD, DARLA R (MD)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:R
Last Name:TOTTEN MD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 NORTHSIDE DR
Mailing Address - Street 2:197
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-2431
Mailing Address - Country:US
Mailing Address - Phone:478-804-1024
Mailing Address - Fax:
Practice Address - Street 1:3780 NORTHSIDE DR
Practice Address - Street 2:197
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2431
Practice Address - Country:US
Practice Address - Phone:478-804-1024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0360262084N0400X
VA01010462592084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology