Healthcare Provider Details
I. General information
NPI: 1235215211
Provider Name (Legal Business Name): DARLENE ALEXANDRA MCNULTY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/31/2006
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
850 MAYFIELD RD STE 203
MILTON GA
30009-3012
US
IV. Provider business mailing address
4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US
V. Phone/Fax
- Phone: 470-805-5040
- Fax: 678-268-4550
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 66551 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: