Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 4301102092 | MI |
N | 207T00000X | Neurosurgeon | 57013073 | OH |
Y | 207T00000X | Neurosurgeon | 8823947-1205 | UT |
NPI | 1053500314 |
---|---|
Provider Name | Chad William Farley |
First Address | Payson, UT 84651-5590 |
Second Address | Payson, UT 84651-5590 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 10/02/2016 |