Provider Demographics
NPI:1518944826
Name:CHIASSON, DARBY CHARLES (OD)
Entity Type:Individual
Prefix:DR
First Name:DARBY
Middle Name:CHARLES
Last Name:CHIASSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16140 WEST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345
Mailing Address - Country:US
Mailing Address - Phone:985-632-2884
Mailing Address - Fax:985-632-6640
Practice Address - Street 1:16140 WEST MAIN ST
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345
Practice Address - Country:US
Practice Address - Phone:985-632-2884
Practice Address - Fax:985-632-6640
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA1271430T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA050583003OtherGREATWEST HEALTHCARE
LA050583003OtherTHE PYRAMID GROUP
LA1566471Medicaid
LAH0056OtherBLUECROSSBLUESHIELD
LA050583003OtherHUMANA MILITARY
LA050583003OtherGILSBAR
LA050583003OtherPYRAMID
LA050583003OtherHUMANA
LA050583003OtherADVANTRA FREEDOM
LA050583003OtherAMERICAN LIFECARE
LA050583003OtherCIGNA GOVERNMENT SERVICES
LA050583003OtherBENEFIT MANAGEMENT
LA050583003OtherCONSOLIDATED HEALTHCARE
LA050583003OtherPPOPLUS
LA050583003OtherAPW HEALTH PLAN
LA050583003OtherOFFICE OF GROUP BENEFITS
LA050583003OtherPPOPLUS
4B254CP49Medicare ID - Type Unspecified