Provider Demographics
NPI:1740379718
Name:DONALD J DIGBY MD PA
Entity Type:Organization
Organization Name:DONALD J DIGBY MD PA
Other - Org Name:DIGBY EYEWEAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIGBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:336-230-1455
Mailing Address - Street 1:719 GREEN VALLEY RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7022
Mailing Address - Country:US
Mailing Address - Phone:336-230-1455
Mailing Address - Fax:
Practice Address - Street 1:719 GREEN VALLEY RD
Practice Address - Street 2:SUITE 105
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7022
Practice Address - Country:US
Practice Address - Phone:336-230-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC7787332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4250320001Medicare NSC