Healthcare Provider Details

I. General information

NPI: 1093915787
Provider Name (Legal Business Name): GINGER L DARLING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N 9TH ST SUITE 4W16
SPRINGFIELD IL
62702-5303
US

IV. Provider business mailing address

PO BOX 19676
SPRINGFIELD IL
62794-9676
US

V. Phone/Fax

Practice location:
  • Phone: 217-757-6429
  • Fax: 217-757-6488
Mailing address:
  • Phone: 217-757-6429
  • Fax: 217-757-6488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number2004012237
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: