Individual
MR. FARZAD FARYABI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2475 LAKELAND DRIVE, SUITE B, JACKSON, MS 39232
(601) 936-3445
(601) 936-7434
Mailing address
2475 LAKELAND DRIVE, SUITE B, JACKSON, MS 39232
(601) 936-3445
(601) 936-7434
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
80147
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120443
—
MS
01
—
4354890001
PALMETTO DME
—
Enumeration date
10/03/2006
Last updated
07/08/2007
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