Provider Demographics
NPI:1558374850
Name:FARMER, WILLIAM M (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:FARMER
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 1:9 E CADBURY LN
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-5518
Mailing Address - Country:US
Mailing Address - Phone:601-596-3632
Mailing Address - Fax:601-268-5185
Practice Address - Street 1:100 METHODIST BLVD
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1295
Practice Address - Country:US
Practice Address - Phone:601-268-5185
Practice Address - Fax:601-268-5185
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18326207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0959507Medicaid
AL9966765Medicaid
MSH97918Medicare UPIN
MS930002934Medicare PIN