Individual
JOSEPH PETER FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
110 N ELM AVE, JACKSON, MI 49202-3571
(517) 788-6760
(517) 788-3029
Mailing address
DEPARTMENT 272801, PO BOX 67000, DETROIT, MI 48267-2728
(517) 841-6913
(517) 841-6917
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34.007479
OH
207P00000X
Emergency Medicine Physician
5101015920
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4728554
—
MI
01
—
P00237166
RR MEDICARE
MI
Enumeration date
04/26/2006
Last updated
07/09/2020
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