Healthcare Provider Details

I. General information

NPI: 1700858347
Provider Name (Legal Business Name): DARREN W GOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DARREN W. GOFF M.D.

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4140 W MEMORIAL RD SUITE 215
OKLAHOMA CITY OK
73120-8366
US

IV. Provider business mailing address

4401 W MEMORIAL RD SUITE 140
OKLAHOMA CITY OK
73134-1785
US

V. Phone/Fax

Practice location:
  • Phone: 405-242-4030
  • Fax: 405-242-4031
Mailing address:
  • Phone: 405-752-3162
  • Fax: 405-936-5211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20279
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: