Organization
JOHN S. FARRELL, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN S FARRELL M.D. (PRESIDENT)
(314) 251-6966
Entity
Organization
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 584A, SAINT LOUIS, MO 63141-8232
(314) 251-6966
(314) 251-6632
Mailing address
621 S NEW BALLAS RD, SUITE 584A, SAINT LOUIS, MO 63141-8232
(314) 251-6966
(314) 251-6632
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
R5636
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200162204
—
MO
01
—
21591
BLUE CROSS BLUE SHIELD
MO
01
—
2900001
UHC
MO
01
—
7014353
ESSENCE
MO
Enumeration date
08/13/2008
Last updated
05/27/2009
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