Provider Demographics
NPI:1063699650
Name:FARMER, BARRY J (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:J
Last Name:FARMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 N YORK ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-3863
Mailing Address - Country:US
Mailing Address - Phone:918-683-3451
Mailing Address - Fax:918-683-1116
Practice Address - Street 1:806 N YORK ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-3863
Practice Address - Country:US
Practice Address - Phone:918-683-3451
Practice Address - Fax:918-683-1116
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK33851223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry