Provider Demographics
NPI:1558619825
Name:FARRIS, MARY ANNE CONSTANCE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY ANNE
Middle Name:CONSTANCE
Last Name:FARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1755 HERITAGE TRL STE 601
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-7600
Mailing Address - Country:US
Mailing Address - Phone:239-529-2581
Mailing Address - Fax:239-331-8287
Practice Address - Street 1:1755 HERITAGE TRL STE 601
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-7600
Practice Address - Country:US
Practice Address - Phone:239-529-2581
Practice Address - Fax:239-331-8287
Is Sole Proprietor?:No
Enumeration Date:2012-08-17
Last Update Date:2021-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME125064207Q00000X
OH57.021228207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine