MEDICARE: DR. PAUL S DARBY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	MD00040014	WA
2	2083X0100X	Occupational Medicine Physician	MD00040014	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07-07402	OTHER	IL	MEDICAL REVIEW OFFICER CERTIFICATION COUNCIL

General Provider Information

NPI Number	:	1366408353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL S DARBY MD

Provider Business Mailing Address
First Line	:	MD PHD SERVICES, PLLC
Second Line	:	1901 65TH AVENUE WEST, SUITE 250
City	:	TACOMA
State	:	WA
Zip	:	98466
Country	:	US
Telephone Number	:	253-480-5884
Fax Number	:	425-728-5753

Provider Business Practice Location Address
First Line	:	PAUL S. DARBY, MD, PHD, P.S.
Second Line	:	1901 65TH AVENUE WEST, SUITE 250
City	:	TACOMA
State	:	WA
Zip	:	98466
Country	:	US
Telephone Number	:	253-480-5884
Fax Number	:	425-728-5753

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	06/10/2024

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