Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 20791 | WI |
NPI | 1376511865 |
---|---|
Provider Name | Philip M Farrell |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 04/02/2009 |