Provider Demographics
NPI:1649470147
Name:DARBY, NATHAN CHAMBERS (MD)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:CHAMBERS
Last Name:DARBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:415 S 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-7246
Mailing Address - Country:US
Mailing Address - Phone:601-268-5630
Mailing Address - Fax:601-579-5240
Practice Address - Street 1:103 TATUM PARK
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401
Practice Address - Country:US
Practice Address - Phone:601-268-5630
Practice Address - Fax:601-268-5819
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21106207QS0010X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02157599Medicaid
MS6041809OtherHEALTHSPRING
MS4649886OtherCIGNA
MS9041558OtherAETNA
MS4649886OtherCIGNA