Individual
DR. BRADLEY A FARLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
144 W HILL ST, WABASH, IN 46992-3048
(260) 563-2020
(260) 563-2873
Mailing address
PO BOX 647, WABASH, IN 46992-0647
(260) 563-2020
(260) 563-2873
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18002054A
IN
152WC0802X
Corneal and Contact Management Optometrist
Primary
18002054A
IN
152WP0200X
Pediatric Optometrist
18002054A
IN
152WS0006X
Sports Vision Optometrist
18002054A
IN
152WX0102X
Occupational Vision Optometrist
18002054A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000088323
ANTHEM BLUE CROSS & SHIEL
IN
05
—
100253500B
—
IN
01
—
134927
EYEMED VISION CARE
IN
Enumeration date
01/13/2006
Last updated
09/04/2009
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