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General NPI Number Information
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NPI Number | 1841663937
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Entity Type | Individual
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Provider Name | WILLIAM DEAN FARNSWORTH HIS
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Gender | Male
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 1699 S 14TH ST SUITE 15
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-1963
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Country | US
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Telephone | 904-277-3265
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Fax |
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Provider Business Mailing Address
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Address Line | 101 E. SUNSET RD. UNIT 96595
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City | LAS VEGAS
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State | NV
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Zip | 89193-1246
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Country | US
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Telephone | 702-798-0113
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Fax | 866-291-5242
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS5133
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License Number State | FL
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