Individual
DR. EDWARD P FARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-5615
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-5615
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
RT-1455
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07721059
—
MS
05
—
157569
—
AL
05
—
2179578
—
LA
01
—
P01233211
RAILROAD MEDICARE
MS
Enumeration date
10/03/2006
Last updated
04/02/2014
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