Individual
DR. FARRAH RAE VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
136 S WILSON ST, DRESDEN, TN 38225-1133
(731) 364-4900
(731) 352-4459
Mailing address
205 HOSPITAL DR, SUITE A, MC KENZIE, TN 38201-1649
(731) 352-7907
(731) 352-4459
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
05202
KY
207Q00000X
Family Medicine Physician
2012004806
MO
207Q00000X
Family Medicine Physician
Primary
DO000000517
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05202
KY LICENSE
KY
01
—
3380640
MEDICARE GROUP
TN
Enumeration date
07/29/2010
Last updated
08/02/2023
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