Provider Demographics
NPI:1841761962
Name:DARBY, NATHAN (HIS)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:
Last Name:DARBY
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17200 CHENAL PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5960
Mailing Address - Country:US
Mailing Address - Phone:501-432-7464
Mailing Address - Fax:501-232-2632
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?:Yes
Enumeration Date:2018-12-16
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR647237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1023552890OtherNPI OF PLLC