Individual
TILLMAN FARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1115 2ND ST, FORT LUPTON, CO 80621-1745
(303) 857-2771
(720) 322-9434
Mailing address
203 S ROLLIE AVE, FORT LUPTON, CO 80621-1508
(303) 857-2771
(720) 322-9434
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0035760
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01357607
—
CO
Enumeration date
12/15/2005
Last updated
11/07/2013
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