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General NPI Number Information
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NPI Number | 1508045485
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Entity Type | Organization
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Legal Business Name | PATRICK M. FARRELL, DPM INC
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 11551 S FORTUNA RD STE A
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City | YUMA
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State | AZ
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Zip | 85367-7858
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Country | US
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Telephone | 928-342-1588
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Fax | 928-342-2289
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Provider Business Mailing Address
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Address Line | 11551 S FORTUNA RD STE A
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City | YUMA
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State | AZ
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Zip | 85367
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Country | US
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Telephone | 928-342-1588
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Fax | 928-342-2289
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PATRICK M. FARRELL
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Credential | DPM
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Telephone | 928-342-1588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 334
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License Number State | AZ
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