Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | R6130 | MO |
NPI | 1073515151 |
---|---|
Provider Name | Dr. Barry S Farber |
First Address | Springfield, MO 65807-5287 |
Second Address | Springfield, MO 65807-5287 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 28/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200346625 | (05) | MO |
A12524 | (02) | MO |
R6130 | STATE LICENSE (01) | MO |