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Organization
OBG-1 A MEDICAL CORPORATION
Active
Organization
OBG-1 A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD BEN DARBY M.D. (PRESIDENT)
(337) 312-1000
Entity
Organization
Contact information
Practice address
1200 STELLY LN, SULPHUR, LA 70663-5134
(337) 312-1000
(337) 312-1001
Mailing address
PO BOX 4610, LAKE CHARLES, LA 70606-4610
(337) 312-1000
(337) 312-1001
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1948250
—
LA
01
—
5BC68
MEDICARE GROUP PROVIDER NUMBER
LA
Enumeration date
06/05/2007
Last updated
06/18/2008
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