Provider Demographics
NPI:1538155148
Name:DARJI, THAKORBHAI B (MD)
Entity type:Individual
Prefix:DR
First Name:THAKORBHAI
Middle Name:B
Last Name:DARJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:T.
Other - Middle Name:B
Other - Last Name:DARJI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:33650 HIGHWAY 43
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THOMASVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36784-3336
Mailing Address - Country:US
Mailing Address - Phone:334-636-1840
Mailing Address - Fax:334-636-2942
Practice Address - Street 1:33650 HIGHWAY 43
Practice Address - Street 2:SUITE 200
Practice Address - City:THOMASVILLE
Practice Address - State:AL
Practice Address - Zip Code:36784-3336
Practice Address - Country:US
Practice Address - Phone:334-636-1840
Practice Address - Fax:334-636-2942
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15443207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51093238OtherBLUE CROSS PROVIDER NUMBE
006895400OtherFEDERAL BLACK LUNG PROGRA
4359409OtherAETNA INSURANCE
1390687ROtherCNA
582026130OtherHUMANA TRICARE
1541229OtherUNITED MINE WORKERS
AL000093238Medicaid
2596463OtherGHI
2596463OtherGHI
110205033Medicare ID - Type UnspecifiedPALMETTO GBA
000093238Medicare ID - Type Unspecified