Provider Demographics
NPI:1083605554
Name:FARLEY, MEGAN JOYCE (MD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JOYCE
Last Name:FARLEY
Suffix:
Gender:F
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:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-535-7445
Practice Address - Street 1:725 JESSE JEWELL PKWY SE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3834
Practice Address - Country:US
Practice Address - Phone:770-535-3611
Practice Address - Fax:770-535-7092
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054209208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA045861129AMedicaid
GA045861129DMedicaid
GA302573OtherWELLCARE
GA302574OtherWELLCARE
GA302575OtherWELLCARE
GA52887377OtherBCBS
GA045861129BMedicaid
GA1202041OtherUNITED HEALTHCARE
GA045861129GMedicaid
GA045861129FMedicaid
GA3027877OtherCIGNA
GA7154125OtherAETNA
GA045861129CMedicaid
GA10032997OtherAMERIGROUP
GA302570OtherWELLCARE
GA302575OtherWELLCARE