Healthcare Provider Details

I. General information

NPI: 1518285584
Provider Name (Legal Business Name): JOSEPH L FARNAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 POWEL AVENUE
NEWPORT RI
02840
US

IV. Provider business mailing address

20 POWEL AVENUE
NEWPORT RI
02840
US

V. Phone/Fax

Practice location:
  • Phone: 401-846-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number14057
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number14057
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: