Individual
DR. MICHAEL DOUGLAS FARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
113 COUNTRY CLUB DR NE, CONCORD, NC 28025-2935
(704) 786-7600
(704) 792-2131
Mailing address
113 COUNTRY CLUB DR NE, CONCORD, NC 28025-2935
(704) 786-7600
(704) 792-2131
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1117
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1117
STATE LICENSE
NC
05
—
890914J
—
NC
Enumeration date
06/09/2005
Last updated
07/08/2007
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