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General NPI Number Information
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NPI Number | 1538237391
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Entity Type | Individual
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Provider Name | JAMES ROBERT FARRAGE JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 05/14/2020
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Provider Practice Location Address
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Address Line | 1725 MCINTOSH ST
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City | BOWLING GREEN
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State | KY
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Zip | 42104-1037
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Country | US
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Telephone | 270-793-9229
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Fax | 270-793-9076
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Provider Business Mailing Address
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Address Line | 1725 MCINTOSH ST
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City | BOWLING GREEN
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State | KY
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Zip | 42104-1037
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Country | US
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Telephone | 270-782-9617
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 17821
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 29032
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD0000025621
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License Number State | TN
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