Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 0101257716 | VA |
N | 207T00000X | Neurosurgeon | 52250 | KY |
NPI | 1073766150 |
---|---|
Provider Name | Dr. Brian Thomas Farrell |
First Address | Newport News, VA 23601-1318 |
Second Address | Newport News, VA 23601-2344 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2008 |
Last Update Date | 22/03/2019 |