# OBG-1 A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629270137
- **Authorized official:** DR. EDWARD BEN DARBY M.D. (PRESIDENT)
- **Authorized official phone:** (337) 312-1000

## Contact information

- **Practice address:** 1200 STELLY LN, SULPHUR, LA 70663-5134
- **Practice address phone:** (337) 312-1000
- **Practice address fax:** (337) 312-1001
- **Mailing address:** PO BOX 4610, LAKE CHARLES, LA 70606-4610
- **Mailing address phone:** (337) 312-1000
- **Mailing address fax:** (337) 312-1001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2007
- **Last updated:** 06/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1948250 | — | LA |
| 01 | — | 5BC68 | MEDICARE GROUP PROVIDER NUMBER | LA |