Provider Demographics
NPI:1699710087
Name:FARAGHER, WILLIAM E (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:FARAGHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3831
Mailing Address - Country:US
Mailing Address - Phone:970-765-0818
Mailing Address - Fax:970-497-8410
Practice Address - Street 1:5 HILLCREST PLAZA WAY
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5876
Practice Address - Country:US
Practice Address - Phone:970-615-7223
Practice Address - Fax:970-615-7226
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CODR.0042726208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00836931OtherRAILROAD WORKERS MEDICARE FOR ROCKY MOUNTAIN REHABILITATION
CO95008853Medicaid
CO41233OtherMEDICARE B PTAN FOR ROCKY MOUNTAIN REHABILITATION
538058Medicare PIN