Provider Demographics
NPI:1962530089
Name:ANN K FARRER DPM PSC
Entity type:Organization
Organization Name:ANN K FARRER DPM PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:859-745-7890
Mailing Address - Street 1:172 PEDRO WAY
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-8354
Mailing Address - Country:US
Mailing Address - Phone:859-745-7890
Mailing Address - Fax:859-745-7891
Practice Address - Street 1:172 PEDRO WAY
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-8354
Practice Address - Country:US
Practice Address - Phone:859-745-7890
Practice Address - Fax:859-745-7891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00208213E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00265302OtherRAILROAD MEDICARE
KY90011735OtherMEDICAID DME
KYDD9986OtherRAILROAD MEDICARE
KY80002082Medicaid
KY5459010001Medicare NSC
KYDD9986OtherRAILROAD MEDICARE
KY80002082Medicaid