Individual
DEMETRIOUS FARROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4120 W MEMORIAL RD, STE 300, OKLAHOMA CITY, OK 73120-9322
(405) 748-3300
(405) 748-2920
Mailing address
4120 W MEMORIAL RD, STE 300, OKLAHOMA CITY, OK 73120-9322
(405) 748-3300
(405) 748-2920
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1249
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200019520A
—
OK
Enumeration date
10/20/2005
Last updated
06/07/2011
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