Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 44143 | AZ |
Y | 207VX0201X | Gynecologic Oncologist | 44143 | AZ |
NPI | 1427034578 |
---|---|
Provider Name | Dr. John Hall Farley |
First Address | Phoenix, AZ 85012-2716 |
Second Address | Phoenix, AZ 85004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 25/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
620575 | (05) | AZ |
Z147683 | (02) | AZ |