Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 85073 | GA |
N | 2086S0105X | Surgery of the Hand | BP10066100 | TX |
NPI | 1346564234 |
---|---|
Provider Name | Dr. Travis Dalton Farmer |
First Address | Savannah, GA 31405-6736 |
Second Address | Rincon, GA 31326-5167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2010 |
Last Update Date | 18/11/2020 |