Organization
DR. FARRELL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK EDWARD FARRELL MD (PROVIDER)
(208) 705-3199
Entity
Organization
Contact information
Practice address
301 W MYRTLE ST, BOISE, ID 83702
(208) 342-8200
(208) 342-8202
Mailing address
967 E PARKCENTER BLVD # 273, BOISE, ID 83706-6721
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
M-6441
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010158339
BLUE SHIELD OF IDAHO
ID
05
—
003692900
—
ID
01
—
76755
BLUE CROSS OF IDAHO
ID
Enumeration date
07/16/2007
Last updated
08/13/2019
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