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Organization

JOHANN FARLEY MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHANN DAVID FARLEY M.D. (PRESIDENT)
(219) 801-2665
Entity
Organization

Contact information

Practice address
8300 BROADWAY STE D2, MERRILLVILLE, IN 46410-8603
(219) 649-0044
(219) 649-0055
Mailing address
8300 BROADWAY STE D2, MERRILLVILLE, IN 46410-8603
(219) 649-0044
(219) 649-0055

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
01060680A
IN
261QP2300X
Primary Care Clinic/Center
46905-20
WI
261QP2300X
Primary Care Clinic/Center
A89493
CA

Other

Enumeration date
01/29/2007
Last updated
03/26/2024
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