Individual
DR. WALTER JOE FARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1423 N JEFFERSON AVE, SPRINGFIELD, MO 65802-1917
(417) 269-6583
(417) 269-6573
Mailing address
1304 E REPUBLIC RD, BOX 205, SPRINGFIELD, MO 65804-7210
(417) 269-6583
(417) 269-6573
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R3G13
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202378725
—
MO
Enumeration date
10/04/2005
Last updated
08/28/2015
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