Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 057456 | GA |
Y | 2081P2900X | Pain Medicine | N2070 | TX |
NPI | 1346295920 |
---|---|
Provider Name | Ainsworth B Farrell |
First Address | Frisco, TX 75034-0051 |
Second Address | Mckinney, TX 75070-3145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 09/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
214893401 | (05) | TX |
214893402 | (05) | TX |
214893403 | (05) | TX |
696884648A | (05) | GA |
696884648B | (05) | GA |
I52437 | (02) | GA |