Healthcare Provider Details

I. General information

NPI: 1598755100
Provider Name (Legal Business Name): ROBERT DARRIN HURST D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 11/13/2022
Certification Date: 11/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 WAYNE RD
SAVANNAH TN
38372-1944
US

IV. Provider business mailing address

425 WAYNE RD
SAVANNAH TN
38372-1944
US

V. Phone/Fax

Practice location:
  • Phone: 731-925-9788
  • Fax: 731-925-8928
Mailing address:
  • Phone: 731-925-9788
  • Fax: 731-925-8928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number565
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: