Provider Demographics
NPI:1982630463
Name:FINLAY, DARRELL GLENN (MD)
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:GLENN
Last Name:FINLAY
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 1:4511 HOSPITAL ST
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39581-5336
Mailing Address - Country:US
Mailing Address - Phone:228-769-7791
Mailing Address - Fax:228-769-7747
Practice Address - Street 1:4511 HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5336
Practice Address - Country:US
Practice Address - Phone:228-769-7791
Practice Address - Fax:228-769-7747
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19116207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS08373277Medicaid
MSI58066Medicare UPIN
MS08373277Medicaid