Provider Demographics
NPI:1831084037
Name:FARRIS, LYDIA
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:FARRIS
Suffix:
Gender:F
Credentials:
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 501593
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-6593
Mailing Address - Country:US
Mailing Address - Phone:317-607-3941
Mailing Address - Fax:317-607-3941
Practice Address - Street 1:1502 SOUTHPARK CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-7489
Practice Address - Country:US
Practice Address - Phone:317-607-3941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management