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General NPI Number Information
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NPI Number | 1629270137
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Entity Type | Organization
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Legal Business Name | OBG-1 A MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 1200 STELLY LN
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City | SULPHUR
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State | LA
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Zip | 70663-5134
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Country | US
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Telephone | 337-312-1000
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Fax | 337-312-1001
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Provider Business Mailing Address
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Address Line | PO BOX 4610
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City | LAKE CHARLES
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State | LA
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Zip | 70606-4610
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Country | US
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Telephone | 337-312-1000
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Fax | 337-312-1001
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD BEN DARBY
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Credential | M.D.
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Telephone | 337-312-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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