Individual
DR. TIMOTHY D. FARLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 S KIRKWOOD RD, SUITE 120, SAINT LOUIS, MO 63122-7254
(314) 966-8887
(314) 966-3869
Mailing address
83 POINTER LN, SAINT LOUIS, MO 63124-2018
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
2003018076
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072286
EXCLUSIVE CHOICE
MO
01
—
180897
BLUE CROSS BLUE SHIELD
MO
01
—
237373
GREAT WEST
MO
01
—
564710
HEALTHLINK
MO
01
—
7301407
AETNA
MO
01
—
9292884
PROAMERICA
MO
01
—
H75475
MERCY #80
MO
Enumeration date
01/10/2006
Last updated
07/09/2007
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