Individual
TIMOTHY P. FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
500 J. CLYDE MORRIS BLVD, RIVERSIDE REGIONAL MEDICAL CENTER, NEWPORT NEWS, VA 23601-1929
(757) 594-4405
(757) 594-3547
Mailing address
PO BOX 12087, NEWPORT NEWS, VA 23612-2087
(757) 867-6101
(757) 867-6587
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101242863
VA
2085R0204X
Vascular & Interventional Radiology Physician
0101242863
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891781571
—
VA
01
—
P00610660
RAILROAD
VA
Enumeration date
09/27/2005
Last updated
11/26/2013
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