Healthcare Provider Details

I. General information

NPI: 1447243142
Provider Name (Legal Business Name): JULIE ANN FARROW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 MOUNTAIN CITY RD
CLAYTON GA
30525-3072
US

IV. Provider business mailing address

PO BOX 2442
COLUMBUS GA
31902-2442
US

V. Phone/Fax

Practice location:
  • Phone: 706-960-9533
  • Fax: 706-782-0465
Mailing address:
  • Phone: 706-782-3100
  • Fax: 706-782-6897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberK4683
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2012-00907
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number83418
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: