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1568671204

NPI Code Detail

MEDICARE: DR. RORY COVETTE FARRIS MD

MEDICARE: DR. RORY COVETTE FARRIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	27062	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1568671204	OTHER	AL	MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	515-99807	OTHER	AL	BCBS OF AL - ENTERPRISE
3	511-30529	OTHER	AL	BCBS OF AL - HEALTHWEST
4	510-65889	OTHER	AL	BCBS OF AL - GENEVA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568671204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RORY COVETTE FARRIS MD

Provider Business Mailing Address
First Line	:	PO BOX 729
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36302-0729
Country	:	US
Telephone Number	:	334-793-2663
Fax Number	:	334-836-2247

Provider Business Practice Location Address
First Line	:	404 N MAIN ST
Second Line	:
City	:	ENTERPRISE
State	:	AL
Zip	:	36330-2563
Country	:	US
Telephone Number	:	334-308-9797
Fax Number	:	334-308-2909

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	11/20/2014

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Directions to “ DR. RORY COVETTE FARRIS MD” Practice Location

Language	Start Address	Practice Location

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