Provider Demographics
NPI:1265601876
Name:ROBERT DARRIN HURST DPM WEST TENNESSEE FOOT CLINIC
Entity type:Organization
Organization Name:ROBERT DARRIN HURST DPM WEST TENNESSEE FOOT CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DARRIN
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-286-1406
Mailing Address - Street 1:129 PRATT DR
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-6026
Mailing Address - Country:US
Mailing Address - Phone:662-286-1406
Mailing Address - Fax:662-286-1408
Practice Address - Street 1:129 PRATT DR
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-6026
Practice Address - Country:US
Practice Address - Phone:662-286-1406
Practice Address - Fax:662-286-1408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS80185332B00000X
213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS4182970002Medicare NSC
U83739Medicare UPIN