1538155148 NPI number — DR. THAKORBHAI B DARJI M.D.

Table of content: DR. THAKORBHAI B DARJI M.D. (NPI 1538155148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538155148 NPI number — DR. THAKORBHAI B DARJI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DARJI
Provider First Name:
THAKORBHAI
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DARJI
Provider Other First Name:
T.
Provider Other Middle Name:
B.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1538155148
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/16/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33650 HIGHWAY 43
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
THOMASVILLE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36784-3336
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-636-1840
Provider Business Mailing Address Fax Number:
334-636-2942

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33650 HIGHWAY 43
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
THOMASVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36784-3336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-636-1840
Provider Business Practice Location Address Fax Number:
334-636-2942
Provider Enumeration Date:
09/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  15443 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 51093238 . This is a "BLUE CROSS PROVIDER NUMBE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 006895400 . This is a "FEDERAL BLACK LUNG PROGRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4359409 . This is a "AETNA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1390687R . This is a "CNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 582026130 . This is a "HUMANA TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1541229 . This is a "UNITED MINE WORKERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000093238 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2596463 . This is a "GHI" identifier . This identifiers is of the category "OTHER".




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