Basic Information
| Provider Information | |||||||||
| NPI: | 1750327532 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DARROW | ||||||||
| FirstName: | BRUCE | ||||||||
| MiddleName: | ALVIN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 WALL ST | ||||||||
| Address2: | EASTERN OKLAHOMA MEDICAL CENTER PLAZA | ||||||||
| City: | POTEAU | ||||||||
| State: | OK | ||||||||
| PostalCode: | 749534405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9186353548 | ||||||||
| FaxNumber: | 9186353568 | ||||||||
| Practice Location | |||||||||
| Address1: | 1130 MEDICAL ARTS BLVD STE 250 | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460113431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7652984282 | ||||||||
| FaxNumber: | 7652984989 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2006 | ||||||||
| LastUpdateDate: | 10/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 9385 | OK | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 100093500A | 05 | OK | MEDICAID | 300031383 | 05 | IN | MEDICAID |