Provider Demographics
NPI:1437591047
Name:DARBY, CHARLES W (MA, HIS/D)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:W
Last Name:DARBY
Suffix:
Gender:M
Credentials:MA, HIS/D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19409 BURLINGAME RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-9291
Mailing Address - Country:US
Mailing Address - Phone:501-821-1234
Mailing Address - Fax:
Practice Address - Street 1:17200 CHENAL PKWY STE 170
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-5960
Practice Address - Country:US
Practice Address - Phone:501-432-7464
Practice Address - Fax:501-232-2632
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSHA0607237700000X
TN795237700000X
AR620237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist