Provider Demographics
NPI:1902430937
Name:DR ELIZABETH M DARBY OPTOMETRIST PLLC
Entity Type:Organization
Organization Name:DR ELIZABETH M DARBY OPTOMETRIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:662-715-0806
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MS
Mailing Address - Zip Code:38673-0025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:504 EASEL ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MS
Practice Address - Zip Code:38673
Practice Address - Country:US
Practice Address - Phone:662-234-9394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty