Individual
DR. JAMES ROBERT FARRAGE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1725 MCINTOSH ST, BOWLING GREEN, KY 42104-1037
(270) 793-9229
(270) 793-9076
Mailing address
1725 MCINTOSH ST, BOWLING GREEN, KY 42104-1037
(270) 782-9617
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
17821
NE
208100000X
Physical Medicine & Rehabilitation Physician
Primary
29032
KY
208100000X
Physical Medicine & Rehabilitation Physician
MD0000025621
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000197276
ANTHEM BCBS
KY
01
—
1135464
PASSPORT MEDICAID
KY
01
—
1503324
UMWA
KY
01
—
250005571
RR MEDICARE
KY
05
—
64290323
—
KY
01
—
8145
KENTUCKY WC
KY
Enumeration date
12/01/2006
Last updated
05/14/2020
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