Provider Demographics
NPI:1447422571
Name:FARMER, JOSEPH S IV (PA-C)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:S
Last Name:FARMER
Suffix:IV
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16150 US HIGHWAY 17 N STE C
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-6302
Mailing Address - Country:US
Mailing Address - Phone:910-270-2515
Mailing Address - Fax:
Practice Address - Street 1:16150 US HIGHWAY 17 N STE C
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-6302
Practice Address - Country:US
Practice Address - Phone:910-270-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-01239363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical