Provider Demographics
NPI:1447230693
Name:FARMER, SCOTT A (DPT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:FARMER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 916
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37717-0916
Mailing Address - Country:US
Mailing Address - Phone:865-457-1649
Mailing Address - Fax:865-463-7825
Practice Address - Street 1:1921 N CHARLES G SEIVERS BLVD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-6747
Practice Address - Country:US
Practice Address - Phone:865-457-1649
Practice Address - Fax:865-463-7825
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7259225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3645556Medicaid
TN3645556Medicare ID - Type Unspecified