Individual
DR. MICHAEL JOHN FARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
113 W HICKORY ST, NEOSHO, MO 64850
(417) 455-4276
Mailing address
1411 13000 RD, ALTAMONT, KS 67330-9305
(620) 423-2051
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0430692
KS
207P00000X
Emergency Medicine Physician
2014009219
MO
207P00000X
Emergency Medicine Physician
Primary
E-14204
AR
207Q00000X
Family Medicine Physician
0430692
KS
207Q00000X
Family Medicine Physician
E-14204
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0430692
STATE LICENSE
KS
05
—
200263590A
—
KS
01
—
2014009219
STATE LICENSE
MO
01
—
2500021669
BNDD
MO
Enumeration date
06/20/2005
Last updated
04/21/2026
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