Provider Demographics
NPI:1225252109
Name:FARRAR, CAROL JEAN (OD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:JEAN
Last Name:FARRAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHANDLER DR STE 15
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-1522
Mailing Address - Country:US
Mailing Address - Phone:207-442-0580
Mailing Address - Fax:207-442-0580
Practice Address - Street 1:1 CHANDLER DR STE 15
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-1522
Practice Address - Country:US
Practice Address - Phone:207-442-0580
Practice Address - Fax:207-442-0580
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT 816152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME041501OtherANTHEM
ME2751850OtherAETNA
MEM56091OtherCIGNA HEALTHCARE
ME2751850OtherAETNA