Healthcare Provider Details

I. General information

NPI: 1114846771
Provider Name (Legal Business Name): DERICK FARROW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL CENTER DR
HAZARD KY
41701-9466
US

IV. Provider business mailing address

2532 BICK CREEK RD.
HAZARD KY
41701
US

V. Phone/Fax

Practice location:
  • Phone: 606-435-7200
  • Fax: 859-280-2589
Mailing address:
  • Phone: 606-435-7200
  • Fax: 859-280-2589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: