Individual
DR. PATRICK EDWARD FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 W MYRTLE ST, BOISE, ID 83702-7656
(208) 955-8215
(208) 445-5899
Mailing address
967 E PARKCENTER BLVD, # 273, BOISE, ID 83706-6721
(208) 955-8215
(208) 445-5899
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
M6441
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010158339
BLUE SHIELD OF IDAHO
ID
05
—
003692900
—
ID
01
—
76755
BLUE CROSS OF IDAHO
ID
Enumeration date
05/04/2006
Last updated
01/02/2020
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