Provider Demographics
NPI:1063420438
Name:FARRETT, WILLIAM DANIEL JR (DPM)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DANIEL
Last Name:FARRETT
Suffix:JR
Gender:M
Credentials:DPM
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Mailing Address - Street 1:8671 S QUEBEC ST STE 230
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-5861
Mailing Address - Country:US
Mailing Address - Phone:303-662-0545
Mailing Address - Fax:720-398-3395
Practice Address - Street 1:8671 S QUEBEC ST STE 230
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-5861
Practice Address - Country:US
Practice Address - Phone:303-662-0545
Practice Address - Fax:720-398-3395
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO497213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1578799698OtherGROUP NPI
CO9000153319Medicaid
3893610001OtherPALMETTO
480033567OtherRRW MEDICARE
84153666402OtherPACIFICARE
FA617492OtherBC BS
84153666402OtherPACIFICARE