Individual
DR. GARY L FARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3731 BLVD, STE A, COLONIAL HEIGHTS, VA 23834
(804) 526-3676
(804) 520-5781
Mailing address
3731 BLVD, STE A, COLONIAL HEIGHTS, VA 23834
(804) 526-3676
(804) 520-5781
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000043
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014917
ANTHEM
VA
01
—
410008652A
MEDICARE RR
VA
05
—
9206931
—
VA
Enumeration date
06/07/2006
Last updated
09/26/2011
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