Provider Demographics
NPI:1053352872
Name:NOORI, DARIUS (MD)
Entity type:Individual
Prefix:
First Name:DARIUS
Middle Name:
Last Name:NOORI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-1237
Mailing Address - Country:US
Mailing Address - Phone:405-799-6900
Mailing Address - Fax:
Practice Address - Street 1:204 S RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160
Practice Address - Country:US
Practice Address - Phone:405-759-2138
Practice Address - Fax:405-759-2138
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK219212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200035170AMedicaid