Healthcare Provider Details

I. General information

NPI: 1407464951
Provider Name (Legal Business Name): BRENDAN JAMES FARLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 HARCOURT RD
INDIANAPOLIS IN
46260-2046
US

IV. Provider business mailing address

8501 HARCOURT RD
INDIANAPOLIS IN
46260-2046
US

V. Phone/Fax

Practice location:
  • Phone: 989-573-4787
  • Fax:
Mailing address:
  • Phone: 989-573-4787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number01099073A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: