Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD021577 | TN |
N | 207QA0401X | Family Doctor - Addiction Medicine | MD021577 | TN |
NPI | 1912180852 |
---|---|
Provider Name | Rachel I. Farmer |
First Address | Cordova, TN 38016-2313 |
Second Address | Memphis, TN 38128-5602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2007 |
Last Update Date | 13/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E40942 | (02) | TN |