Provider Demographics
NPI:1750327532
Name:DARROW, BRUCE ALVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ALVIN
Last Name:DARROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WALL ST
Mailing Address - Street 2:EASTERN OKLAHOMA MEDICAL CENTER PLAZA
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-4405
Mailing Address - Country:US
Mailing Address - Phone:918-635-3548
Mailing Address - Fax:918-635-3568
Practice Address - Street 1:1130 MEDICAL ARTS BLVD STE 250
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3431
Practice Address - Country:US
Practice Address - Phone:765-298-4282
Practice Address - Fax:765-298-4989
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9385207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100093500AMedicaid
IN300031383Medicaid
OK243434801Medicare ID - Type Unspecified