Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 3271 | NC |
Y | 213EG0000X | General Practice | 3271 | NC |
NPI | 1003934787 |
---|---|
Provider Name | Dr. Stanley Farrior |
First Address | Burgaw, NC 28425-0874 |
Second Address | Burgaw, NC 28425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8992637 | (05) | NC |