Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 13397 | AZ |
NPI | 1003809872 |
---|---|
Provider Name | Dr. Rhesa Screven Farmer III |
First Address | Tucson, AZ 85719-2380 |
Second Address | Tucson, AZ 85719-2380 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 14/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E00830 | (02) | AZ |