Provider Demographics
NPI:1588984793
Name:FARRIS, JAMES W (PT, PHD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:FARRIS
Suffix:
Gender:M
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:HIGDEN
Mailing Address - State:AR
Mailing Address - Zip Code:72067-0082
Mailing Address - Country:US
Mailing Address - Phone:480-487-5107
Mailing Address - Fax:
Practice Address - Street 1:15 EMERALD WAY
Practice Address - Street 2:
Practice Address - City:GREERS FERRY
Practice Address - State:AR
Practice Address - Zip Code:72067-8023
Practice Address - Country:US
Practice Address - Phone:480-487-5107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8440225100000X
AR2395225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist