Provider Demographics
NPI:1700858347
Name:GOFF, DARREN W (MD)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:W
Last Name:GOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DARREN
Other - Middle Name:W
Other - Last Name:GOFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4401 W MEMORIAL RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1785
Mailing Address - Country:US
Mailing Address - Phone:405-752-3162
Mailing Address - Fax:405-936-5211
Practice Address - Street 1:4140 W MEMORIAL RD
Practice Address - Street 2:SUITE 215
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8366
Practice Address - Country:US
Practice Address - Phone:405-242-4030
Practice Address - Fax:405-242-4031
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20279207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100207560AMedicaid
OK243503401Medicare ID - Type Unspecified
OK100207560AMedicaid