Individual
GUY R. FARMER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
232 STARLYN AVE, NEW ALBANY, MS 38652-2428
(662) 534-5891
(662) 534-5970
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5827
(870) 934-5821
(870) 934-5384
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
14294
MS
208600000X
Surgery Physician
02002767A
IN
208600000X
Surgery Physician
Primary
14294
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000333616
ANTHEM PROVIDER NUMBER
IN
05
—
05924350
—
MS
01
—
11484466
CAQH NUMBER
IN
05
—
200482400
—
IN
01
—
9397057
PHCS PID NUMBER
IN
Enumeration date
03/16/2006
Last updated
04/04/2018
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