Individual
DR. JACK C. FARRIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
KIMBROUGH AMBULATORY CARE CENTER, ATTN: OPTOMETRY, FORT MEADE, MD 21044-5800
(301) 677-8378
(301) 677-8077
Mailing address
11601 SUN CIRCLE WAY, COLUMBIA, MD 21044-4375
(443) 367-0287
(301) 677-8077
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000904
VA
Other
Enumeration date
11/14/2005
Last updated
07/08/2007
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