Provider Demographics
NPI:1760556328
Name:BRITT, DARRYL B (MD)
Entity Type:Individual
Prefix:
First Name:DARRYL
Middle Name:B
Last Name:BRITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 HARLEY ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-4219
Mailing Address - Country:US
Mailing Address - Phone:256-259-1735
Mailing Address - Fax:256-259-8041
Practice Address - Street 1:504 HARLEY ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-4219
Practice Address - Country:US
Practice Address - Phone:256-259-1735
Practice Address - Fax:256-259-8041
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD0000005287208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51079498OtherBLUE CROSS
AL000079498Medicaid
TN3107140OtherBLUE CROSS TN
AL000079498Medicaid
TN3831832Medicare ID - Type UnspecifiedMEDICARE TN
AL000079498Medicare ID - Type UnspecifiedMEICARE