Provider Demographics
NPI:1407017148
Name:DR. ELIZABETH M. DARBY,OPTOMETRIST,PLLC.
Entity type:Organization
Organization Name:DR. ELIZABETH M. DARBY,OPTOMETRIST,PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:DARBY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:434-385-0213
Mailing Address - Street 1:3701B OLD FOREST RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-6947
Mailing Address - Country:US
Mailing Address - Phone:434-385-0213
Mailing Address - Fax:434-385-0214
Practice Address - Street 1:3701B OLD FOREST RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-6947
Practice Address - Country:US
Practice Address - Phone:434-385-0213
Practice Address - Fax:434-385-0214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001306332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
U87176Medicare UPIN
190001479Medicare PIN