Healthcare Provider Details

I. General information

NPI: 1851359582
Provider Name (Legal Business Name): JIMMY L. DARBY KINESIOTHERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 N CALHOUN ST
ELLISVILLE MS
39437-2713
US

IV. Provider business mailing address

506 N CALHOUN ST
ELLISVILLE MS
39437-2713
US

V. Phone/Fax

Practice location:
  • Phone: 601-477-9991
  • Fax:
Mailing address:
  • Phone: 601-477-9991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number1066
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code226300000X
TaxonomyKinesiotherapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: