Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | E-7632 | AR |
Y | 2080P0207X | Pediatric Hematology-Oncologist | E-7632 | AR |
NPI | 1235283581 |
---|---|
Provider Name | Jason Eli Farrar |
First Address | Little Rock, AR 72202-3500 |
Second Address | Little Rock, AR 72202-3500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/08/2012 |