Valerie Lee Farris, M.D.

Individual provider Active NPI Internal Medicine Physician · Jay, OK

NPI 1104807387 · NPPES record last updated Jan 29, 2015

Key facts

NPI
1104807387
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
23261 (OK)
Practice address
1569 N Main St
Jay, OK 74346-2903
Phone
(918) 253-1900
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20171020000977 TX Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
0244144327

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 23261 OK Yes

Addresses

Primary practice location

1569 N Main St
Jay, OK 74346-2903

Mailing address

10842 Highway 82a
Tahlequah, OK 74464-6278
Phone (918) 253-1900

Other identifiers

IdentifierTypeStateIssuer
146994001MedicaidAR
100071900AMedicaidOK

Other providers in Jay, OK

All providers in Jay, OK · Internal Medicine Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.