Provider Demographics
NPI:1497752521
Name:DARBY, DAVID MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARK
Last Name:DARBY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-2840
Mailing Address - Country:US
Mailing Address - Phone:337-364-6543
Mailing Address - Fax:337-364-6564
Practice Address - Street 1:221 N LEWIS ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2840
Practice Address - Country:US
Practice Address - Phone:337-364-6543
Practice Address - Fax:337-364-6564
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAU64495Medicare UPIN
LA5X160Medicare ID - Type UnspecifiedMEDICARE