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Individual

JAMES VANNOY FARIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 331-3402
(812) 355-6549
Mailing address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 331-3402
(812) 355-6549

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01022156A
IN
207RI0011X
Interventional Cardiology Physician
Primary
01022156A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100333020
IN
Enumeration date
06/20/2005
Last updated
09/13/2010
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