Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 35079793F | OH |
NPI | 1801899034 |
---|---|
Provider Name | Tonia L Farmer |
First Address | Warren, OH 44484-4706 |
Second Address | Warren, OH 44484-4706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 16/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2276095 | (05) | OH |
H38020 | (02) | OH |