MEDICARE: DONNA YANCEY FARMER 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
1	207R00000X	Internal Medicine Physician	38817	KY
2	208000000X	Pediatrics Physician	38817	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00238964	OTHER	KY	RR MEDICARE PIN
4	ASC1019	OTHER	KY	ASC MEDICARE GROUP
5	CB5773	OTHER	KY	RR MEDICARE GROUP
7	4000501	OTHER	KY	MEDICARE LAB GROUP

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417982299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA YANCEY FARMER M.D.

Provider Business Mailing Address
First Line	:	1055 DOVE RUN RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-3536
Country	:	US
Telephone Number	:	859-268-0061
Fax Number	:	859-266-1152

Provider Business Practice Location Address
First Line	:	1055 DOVE RUN RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-3536
Country	:	US
Telephone Number	:	859-268-0061
Fax Number	:	859-266-1152

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	03/11/2010

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Directions to “ DONNA YANCEY FARMER M.D.” Practice Location

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