Provider Demographics
NPI:1063476844
Name:FARCHONE, THOMAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:FARCHONE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14231 BEADLE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-8213
Mailing Address - Country:US
Mailing Address - Phone:269-962-0441
Mailing Address - Fax:269-962-0925
Practice Address - Street 1:14231 BEADLE LAKE RD
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-8213
Practice Address - Country:US
Practice Address - Phone:269-962-0441
Practice Address - Fax:269-962-0925
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2014-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301056922207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4094189Medicaid
MI080156672OtherRAILROAD MEDICARE
MI080156672OtherRAILROAD MEDICARE