Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 61808 | GA |
Y | 207PE0004X | Emergency Medical Services | 061808 | GA |
NPI | 1013141118 |
---|---|
Provider Name | Dr. Darren Deandre Naugles |
First Address | Norcross, GA 30093-1291 |
Second Address | Norcross, GA 30093-1291 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2009 |
Last Update Date | 04/02/2021 |