Provider Demographics
NPI:1356683387
Name:HERRON, DARRYN K I
Entity type:Individual
Prefix:MR
First Name:DARRYN
Middle Name:K
Last Name:HERRON
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5641 S 88TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-7905
Mailing Address - Country:US
Mailing Address - Phone:918-955-8833
Mailing Address - Fax:
Practice Address - Street 1:5641 S 88TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-7905
Practice Address - Country:US
Practice Address - Phone:918-955-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)