Healthcare Provider Details

I. General information

NPI: 1942238746
Provider Name (Legal Business Name): JEFF R FARROW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 12/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N STATE OF FRANKLIN ROAD SUITE 303
JOHNSON CITY TN
37604-6051
US

IV. Provider business mailing address

310 N STATE OF FRANKLIN ROAD SUITE 303
JOHNSON CITY TN
37604-6051
US

V. Phone/Fax

Practice location:
  • Phone: 423-926-8181
  • Fax: 423-926-8652
Mailing address:
  • Phone: 423-926-8181
  • Fax: 423-926-8652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number20446
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number20446
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: