Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 07000944A | IN |
NPI | 1114904935 |
---|---|
Provider Name | Dr. Dusky Rideout Farmer |
First Address | Evansville, IN 47712-6421 |
Second Address | Evansville, IN 47712-6421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 09/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200805820 | (05) | IN |
20085820 | (05) | IN |
U93124 | (02) | IN |