Provider Demographics
NPI:1487655296
Name:FARBER, NED WINSLOW (DO)
Entity Type:Individual
Prefix:
First Name:NED
Middle Name:WINSLOW
Last Name:FARBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 COMMERCE WAY
Mailing Address - Street 2:SUITE 180
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2829
Mailing Address - Country:US
Mailing Address - Phone:615-465-7000
Mailing Address - Fax:
Practice Address - Street 1:650 US HIGHWAY 331 S
Practice Address - Street 2:UNIT 4
Practice Address - City:DEFUNIAK SPGS
Practice Address - State:FL
Practice Address - Zip Code:32435-3349
Practice Address - Country:US
Practice Address - Phone:850-892-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO23243207Q00000X
ID0-172207Q00000X
FLOS6872207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276813500Medicaid
FL57108OtherBCBS
FL57108YMedicare PIN
FL276813500Medicaid