Provider Demographics
NPI:1053500314
Name:FARLEY, CHAD WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:WILLIAM
Last Name:FARLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15 S 1000 E
Mailing Address - Street 2:SUITE 225
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-5590
Mailing Address - Country:US
Mailing Address - Phone:801-609-9310
Mailing Address - Fax:
Practice Address - Street 1:15 S 1000 E
Practice Address - Street 2:SUITE 225
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-5590
Practice Address - Country:US
Practice Address - Phone:801-609-9310
Practice Address - Fax:801-465-0901
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57013073207T00000X
MI4301102092207T00000X
UT8823947-1205207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery