Healthcare Provider Details

I. General information

NPI: 1558534321
Provider Name (Legal Business Name): ROBERT DARRIN HURST DPM WEST TENNESSEE FOOT CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
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 Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberDPM0000000565
License Number StateTN

VIII. Authorized Official

Name: ROBERT DARRIN HURST
Title or Position: PODIATRIST
Credential: DPM
Phone: 731-925-9788