Basic Information
Provider Information
NPI: 1457849796
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FERREE
FirstName: DARREN
MiddleName: SCOTT
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 337
Address2:  
City: LAFAYETTE
State: TN
PostalCode: 370830337
CountryCode: US
TelephoneNumber: 6156888160
FaxNumber:  
Practice Location
Address1: 401 SEWELL DR
Address2:  
City: SPARTA
State: TN
PostalCode: 385831223
CountryCode: US
TelephoneNumber: 9317389211
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/23/2018
LastUpdateDate: 06/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X61670TNY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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