Provider Demographics
NPI:1275176836
Name:FARNHAM, JEFFREY (CPO)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:FARNHAM
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 CLEVELAND PL
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6529
Mailing Address - Country:US
Mailing Address - Phone:757-456-5501
Mailing Address - Fax:757-671-7525
Practice Address - Street 1:380 CLEVELAND PL
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6529
Practice Address - Country:US
Practice Address - Phone:757-456-5501
Practice Address - Fax:757-671-7525
Is Sole Proprietor?:No
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist