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NPI Code Detail

MEDICARE: LEE M FARMER MD

MEDICARE: LEE M FARMER MD
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
1208M00000XHospitalist Physician27625AZ
2207R00000XInternal Medicine Physician27625AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2AZ0306770OTHERAZBCBS

General Provider Information

NPI Number : 1508851841
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEE M FARMER MD
Provider Business Mailing Address
First Line : 1200 N BEAVER ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-3118
Country : US
Telephone Number : 928-213-6235
Fax Number : 928-213-6292
Provider Business Practice Location Address
First Line : 269 S CANDY LN
Second Line :
City : COTTONWOOD
State : AZ
Zip : 86326-4158
Country : US
Telephone Number : 928-639-5588
Fax Number : 928-639-5589
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 05/14/2020

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