Provider Demographics
NPI:1629060595
Name:FARRIOR, JOSEPH B III (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:B
Last Name:FARRIOR
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAY
Other - Middle Name:B
Other - Last Name:FARRIOR
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1127 NIKKI VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4879
Mailing Address - Country:US
Mailing Address - Phone:813-571-7184
Mailing Address - Fax:813-654-4695
Practice Address - Street 1:5 TAMPA GENERAL CIR
Practice Address - Street 2:STE 610
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3601
Practice Address - Country:US
Practice Address - Phone:813-315-4327
Practice Address - Fax:813-315-4329
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0033619207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL066174100Medicaid
FL30357YMedicare UPIN
D85526Medicare UPIN