Provider Demographics
NPI:1033130935
Name:FARLEIGH, RICHARD MERLE (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MERLE
Last Name:FARLEIGH
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 1:4120 LAUREL ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5335
Mailing Address - Country:US
Mailing Address - Phone:907-561-4293
Mailing Address - Fax:
Practice Address - Street 1:4120 LAUREL ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5335
Practice Address - Country:US
Practice Address - Phone:907-561-4293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA1693207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1693Medicaid
AKC97073Medicare UPIN
AKMD1693Medicaid