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General NPI Number Information
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NPI Number | 1700885175
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Entity Type | Individual
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Provider Name | JAMES WILLIAM FARRELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 03/21/2013
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Provider Practice Location Address
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Address Line | 101 N PARKWAY DR
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City | PEKIN
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State | IL
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Zip | 61554-3932
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Country | US
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Telephone | 309-347-5115
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Fax | 309-347-7036
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Provider Business Mailing Address
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Address Line | 1008 N MAIN ST
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City | BLOOMINGTON
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State | IL
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Zip | 61701-1784
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Country | US
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Telephone | 800-325-7706
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036078398
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License Number State | IL
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