Provider Demographics
NPI:1407838733
Name:FARMER, CARL N (APRN BC)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:N
Last Name:FARMER
Suffix:
Gender:M
Credentials:APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MEMORIAL DRIVE
Mailing Address - Street 2:HAMILTON MEDICAL CENTER
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720
Mailing Address - Country:US
Mailing Address - Phone:706-272-6876
Mailing Address - Fax:706-272-6877
Practice Address - Street 1:1200 MEMORIAL DR
Practice Address - Street 2:HAMILTON MEDICAL CENTER
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720
Practice Address - Country:US
Practice Address - Phone:706-272-6876
Practice Address - Fax:706-272-6877
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN182931 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS56389Medicare UPIN
FLY5951YMedicare ID - Type UnspecifiedMEDICARE #