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General NPI Number Information
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NPI Number | 1124350301
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Entity Type | Organization
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Legal Business Name | ED FARROW MD PC
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Dates
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Enumeration Date | 02/12/2010
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Last Update Date | 02/12/2010
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Provider Practice Location Address
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Address Line | 218 N MAIN ST
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City | EUFAULA
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State | OK
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Zip | 74432-1633
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Country | US
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Telephone | 918-689-7705
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Fax | 918-689-3889
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Provider Business Mailing Address
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Address Line | 218 N MAIN ST
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City | EUFAULA
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State | OK
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Zip | 74432-1633
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Country | US
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Telephone | 918-689-7705
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Fax | 918-689-3889
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT FARROW
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Credential | MD
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Telephone | 918-689-7705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 13179
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License Number State | OK
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