Basic Information
Provider Information
NPI: 1134168321
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DARRUP
FirstName: CHRIS
MiddleName: JAMES
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7 DOCK HILL RD
Address2:  
City: MIDDLEBURG
State: PA
PostalCode: 178428910
CountryCode: US
TelephoneNumber: 5708372123
FaxNumber: 5708372185
Practice Location
Address1: 1 DOCK HILL RD
Address2:  
City: MIDDLEBURG
State: PA
PostalCode: 178428910
CountryCode: US
TelephoneNumber: 5708375889
FaxNumber: 5708376600
Other Information
ProviderEnumerationDate: 06/05/2006
LastUpdateDate: 04/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XOS008823LPAY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
001816420000105PA MEDICAID


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