Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 497 | CO |
NPI | 1063420438 |
---|---|
Provider Name | Mr. William Daniel Farrett JR. |
First Address | Highlands Ranch, CO 80130-5861 |
Second Address | Highlands Ranch, CO 80130-5861 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 28/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1578799698 | GROUP NPI (01) | CO |
3893610001 | PALMETTO (01) | |
480033567 | RRW MEDICARE (01) | |
84153666402 | PACIFICARE (01) | |
9000153319 | (05) | CO |
FA617492 | BC BS (01) | |
U73688 | (02) |