Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | ME50318 | FL |
NPI | 1518052430 |
---|---|
Provider Name | Dr. Edward H. Farrior |
First Address | Tampa, FL 33609-3110 |
Second Address | Tampa, FL 33609-3110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 29/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D51137 | (02) | FL |