Provider Demographics
NPI:1255485504
Name:FARRELL, PATRICK J (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:FARRELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 W. MAIN STREET
Mailing Address - Street 2:SUITE D
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774
Mailing Address - Country:US
Mailing Address - Phone:301-865-8333
Mailing Address - Fax:301-865-8373
Practice Address - Street 1:164 W. MAIN STREET
Practice Address - Street 2:SUITE D
Practice Address - City:NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21774
Practice Address - Country:US
Practice Address - Phone:301-865-8333
Practice Address - Fax:301-865-8373
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02132111N00000X, 111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0200XChiropractic ProvidersChiropractorRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
U82047Medicare UPIN