Provider Demographics
NPI:1346744984
Name:FARRIS, JOSHUA CALEB (MD/PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:CALEB
Last Name:FARRIS
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:
Other - First Name:NA
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:104 INNOVATION DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5253
Mailing Address - Country:US
Mailing Address - Phone:864-603-6200
Mailing Address - Fax:
Practice Address - Street 1:104 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5253
Practice Address - Country:US
Practice Address - Phone:864-603-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC898792085R0001X
WV390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program