Provider Demographics
NPI:1649707662
Name:ROBERT E DARNABY
Entity type:Organization
Organization Name:ROBERT E DARNABY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:DARNABY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-866-4135
Mailing Address - Street 1:124 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:IN
Mailing Address - Zip Code:47978-2820
Mailing Address - Country:US
Mailing Address - Phone:219-866-4135
Mailing Address - Fax:219-866-0803
Practice Address - Street 1:124 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-2820
Practice Address - Country:US
Practice Address - Phone:219-866-4135
Practice Address - Fax:219-866-0803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INA01028943207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty