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General NPI Number Information
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NPI Number | 1568693992
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Entity Type | Organization
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Legal Business Name | DAVID R. FARMER OD PC
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 5308 PROVIDENCE ROAD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4102
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Country | US
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Telephone | 757-467-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 5308 PROVIDENCE ROAD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4102
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Country | US
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Telephone | 757-467-6200
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. DAVID R FARMER
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Credential | O.D.
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Telephone | 757-467-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618000044
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License Number State | VA
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