Individual
LARRY D FARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3235 E MICHIGAN AVE, JACKSON, MI 49202-3971
(517) 787-8250
(517) 787-1612
Mailing address
PO BOX 67000, DEPT 272801, DETROIT, MI 48267-2728
(517) 787-8250
(517) 787-1612
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
5101007126
MI
207R00000X
Internal Medicine Physician
Primary
5101007126
MI
Other
Enumeration date
09/26/2006
Last updated
12/30/2011
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