Provider Demographics
NPI:1285749499
Name:PARHAM, DARAN L (MD)
Entity type:Individual
Prefix:DR
First Name:DARAN
Middle Name:L
Last Name:PARHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 E 19TH ST
Mailing Address - Street 2:STE 401
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5437
Mailing Address - Country:US
Mailing Address - Phone:918-749-1413
Mailing Address - Fax:918-749-0234
Practice Address - Street 1:1725 E 19TH ST
Practice Address - Street 2:STE 401
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5437
Practice Address - Country:US
Practice Address - Phone:918-749-1413
Practice Address - Fax:918-748-7511
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19513207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100103140BMedicaid
OK200477940AMedicaid