Provider Demographics
NPI:1417982299
Name:FARMER, DONNA YANCEY (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:YANCEY
Last Name:FARMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 DOVE RUN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-3536
Mailing Address - Country:US
Mailing Address - Phone:859-268-0061
Mailing Address - Fax:859-266-1152
Practice Address - Street 1:1055 DOVE RUN RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-3536
Practice Address - Country:US
Practice Address - Phone:859-268-0061
Practice Address - Fax:859-266-1152
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38817207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64088628Medicaid
KY36000818OtherASC MEDICAID GROUP
KYP00238964OtherRR MEDICARE PIN
KYASC1019OtherASC MEDICARE GROUP
KYCB5773OtherRR MEDICARE GROUP
KY37903705OtherMEDICAID LAB GROUP
KY4000501OtherMEDICARE LAB GROUP