MEDICARE: TIFFANY A DARLING 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	208000000X	Pediatrics Physician	47132-20	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871671735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY A DARLING MD

Provider Business Mailing Address
First Line	:	36745 AIKEN RD
Second Line	:
City	:	BAYFIELD
State	:	WI
Zip	:	54814-4579
Country	:	US
Telephone Number	:	715-779-3707
Fax Number	:	715-779-3362

Provider Business Practice Location Address
First Line	:	6791 N GREEN BAY AVE
Second Line	:
City	:	GLENDALE
State	:	WI
Zip	:	53209-3422
Country	:	US
Telephone Number	:	414-228-4800
Fax Number	:	414-247-0894

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	02/02/2023

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Directions to “ TIFFANY A DARLING MD” Practice Location

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