Individual
LAURA BROOKE FARLESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5354 REYNOLDS ST, SAVANNAH, GA 31405-6007
(912) 819-5999
(912) 819-5980
Mailing address
123 GRAYS CREEK DR, SAVANNAH, GA 31410-1042
(205) 960-5105
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
067414
GA
207R00000X
Internal Medicine Physician
27790
AL
207R00000X
Internal Medicine Physician
MD00049416
WA
207R00000X
Internal Medicine Physician
MD28152
OR
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
67414
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00481527
—
MS
01
—
051118047
BCBS
AL
01
—
051118048
BCBS
AL
01
—
051118049
BCBS
AL
01
—
051118051
BCBS
AL
01
—
051118052
BCBS
AL
01
—
051118053
BCBS
AL
01
—
051118055
BCBS
AL
05
—
129905
—
AL
05
—
129906
—
AL
05
—
129907
—
AL
05
—
129909
—
AL
05
—
129912
—
AL
05
—
129914
—
AL
05
—
133118
—
AL
01
—
Z01903
VIVA
AL
Enumeration date
05/03/2007
Last updated
04/13/2023
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