Individual
VALERIE LEE FARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1569 N MAIN ST, JAY, OK 74346-2903
(918) 253-1900
Mailing address
10842 HIGHWAY 82A, TAHLEQUAH, OK 74464-6278
(918) 253-1900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23261
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100071900A
—
OK
05
—
146994001
—
AR
Enumeration date
11/07/2005
Last updated
01/29/2015
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