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General NPI Number Information
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NPI Number | 1821248527
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Entity Type | Individual
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Provider Name | NICHOLAS MARTIN DARBY DDS
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Gender | Male
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Dates
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Enumeration Date | 09/30/2008
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 404 N FRONT ST
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City | RICHTON
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State | MS
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Zip | 39476-2207
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Country | US
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Telephone | 17-886-2386
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 469
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City | RICHTON
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State | MS
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Zip | 39476-0469
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Country | US
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Telephone | 601-788-6238
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3486-08
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3486-08
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License Number State | MS
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