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NPI Code Detail

MEDICARE: DR. THOMAS M. FARLEY M.D.

MEDICARE: DR. THOMAS M. FARLEY M.D.
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
1207L00000XAnesthesiology Physician30895-020WI

Other Identifiers

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

General Provider Information

NPI Number : 1356324990
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS M. FARLEY M.D.
Provider Business Mailing Address
First Line : 225 S EXECUTIVE DR
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-4266
Country : US
Telephone Number : 262-787-4026
Fax Number :
Provider Business Practice Location Address
First Line : 1726 SHAWANO AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-3216
Country : US
Telephone Number : 920-498-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 07/09/2007

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