Provider Demographics
NPI:1053304139
Name:FARRIS, NEIL R (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:R
Last Name:FARRIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1401 HARRODSBURG RD
Mailing Address - Street 2:SUITE C215
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3751
Mailing Address - Country:US
Mailing Address - Phone:859-278-9413
Mailing Address - Fax:859-276-6381
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:SUITE C215
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3751
Practice Address - Country:US
Practice Address - Phone:859-278-9413
Practice Address - Fax:859-276-6381
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2008-06-16
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Provider Licenses
StateLicense IDTaxonomies
KY21397207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000047820OtherANTHEM BLUE SHIELD
KY611012421OtherAETNA
KY611012421BOtherHUMANA
KY0400543OtherUNITED HEALTHCARE
KY110056673OtherRAILROAD MEDICARE
KY1404232OtherUMWA
KY0400356OtherUNITED HEALTHCARE
KY61-1012421OtherTPN CONTRACTS
KY611012421OtherESSENCE
KYC68016OtherBLUEGRASS FAMILY HEALTH
KY0037677OtherMEDICARE - FAYETTE COUNTY HEALTH DEPARTMENT
KY1284109OtherUWMA
KY64-213978Medicaid
KY1404232OtherUMWA
KY611012421OtherAETNA
KY1284109OtherUWMA