Provider Demographics
NPI:1508486101
Name:FARRAR, CAROLINE MORRIS
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MORRIS
Last Name:FARRAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:CAROLINE
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:127 CRESTVIEW PARK DR STE 209
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2856
Mailing Address - Country:US
Mailing Address - Phone:615-446-5121
Mailing Address - Fax:
Practice Address - Street 1:127 CRESTVIEW PARK DR STE 112
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2854
Practice Address - Country:US
Practice Address - Phone:615-441-4533
Practice Address - Fax:615-441-4593
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD64769207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine