MEDICARE: DONALD R FARLEY DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	36.002243	OH
2	213E00000X	Podiatrist	36002243	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093783466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD R FARLEY DPM

Provider Business Mailing Address
First Line	:	1604 WEST 19TH STREET
Second Line	:
City	:	ASHTABULA
State	:	OH
Zip	:	44004
Country	:	US
Telephone Number	:	440-964-5595
Fax Number	:	440-964-5003

Provider Business Practice Location Address
First Line	:	161 E WASHINGTON ST
Second Line	:
City	:	PAINESVILLE
State	:	OH
Zip	:	44077-3449
Country	:	US
Telephone Number	:	440-352-2201
Fax Number	:	440-352-0242

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	04/02/2024

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Directions to “ DONALD R FARLEY DPM” Practice Location

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