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Individual

DR. JOHN EDWARD FARRAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
2200 GULLICK AVE, WINN ARMY COMMUNITY HOSPITAL, BLDG 816, FORT STEWART, GA 31314-5674
(770) 862-6519
Mailing address
2 OLEANDER ST, HILTON HEAD ISLAND, SC 29928-5502
(770) 862-6519

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1004
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000415324A
GA
Enumeration date
11/06/2006
Last updated
05/17/2010
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