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General NPI Number Information
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NPI Number | 1669931978
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Entity Type | Individual
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Provider Name | JEFFREY ALLEN FARVOUR MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2019
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 414 DOCTORS CT
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City | OSHKOSH
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State | WI
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Zip | 54901-2065
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Country | US
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Telephone | 920-303-5100
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Fax | 920-303-4079
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Provider Business Mailing Address
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Address Line | 414 DOCTORS CT
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City | OSHKOSH
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State | WI
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Zip | 54901-2065
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Country | US
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Telephone | 920-303-5100
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Fax | 920-303-5205
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 74892-20
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License Number State | WI
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