Healthcare Provider Details

I. General information

NPI: 1013002609
Provider Name (Legal Business Name): DARREN W GOFF MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4140 W MEMORIAL RD SUITE 215
OKLAHOMA CITY OK
73120
US

IV. Provider business mailing address

4140 W MEMORIAL RD SUITE 215
OKLAHOMA CITY OK
73120
US

V. Phone/Fax

Practice location:
  • Phone: 405-242-4030
  • Fax: 405-242-4031
Mailing address:
  • Phone: 405-242-4030
  • Fax: 405-242-4031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number20279
License Number StateOK

VIII. Authorized Official

Name: MRS. KIMBERLY S HORN
Title or Position: INSURANCE CORDINATOR
Credential: CPC
Phone: 405-242-4036