Provider Demographics
NPI:1235246356
Name:FARMER, MONROE NEWTON JR (OD)
Entity Type:Individual
Prefix:DR
First Name:MONROE
Middle Name:NEWTON
Last Name:FARMER
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:82 COWPASTURE RIVER HWY
Mailing Address - Street 2:
Mailing Address - City:CLIFTON FORGE
Mailing Address - State:VA
Mailing Address - Zip Code:24422-9001
Mailing Address - Country:US
Mailing Address - Phone:540-862-2225
Mailing Address - Fax:
Practice Address - Street 1:4802 VALLEY VIEW BLVD.,NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012
Practice Address - Country:US
Practice Address - Phone:540-563-8279
Practice Address - Fax:540-563-5598
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001466152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T32528Medicare UPIN