Provider Demographics
NPI:1518548866
Name:DARBY, DEREK LAMONT JR (MD)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:LAMONT
Last Name:DARBY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:777 HEMLOCK STREET MSC #104
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201
Mailing Address - Country:US
Mailing Address - Phone:478-633-7550
Mailing Address - Fax:478-633-3235
Practice Address - Street 1:777 HEMLOCK STREET MSC #104
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201
Practice Address - Country:US
Practice Address - Phone:478-633-7550
Practice Address - Fax:478-633-3235
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA98855207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty