Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 2001022823 | MO |
NPI | 1013951250 |
---|---|
Provider Name | Dr. Christopher D. Farmer |
First Address | Columbia, MO 65201-7199 |
Second Address | Columbia, MO 65201-7199 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 24/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H88747 | (02) | MO |