Provider Demographics
NPI:1649244351
Name:FARMER, CRAIG J (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:J
Last Name:FARMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:CRAIG
Other - Middle Name:J
Other - Last Name:FARMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:12157 W LINEBAUGH AVE
Mailing Address - Street 2:317
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1732
Mailing Address - Country:US
Mailing Address - Phone:727-787-3911
Mailing Address - Fax:727-724-1740
Practice Address - Street 1:3165 N MCMULLEN BOOTH RD
Practice Address - Street 2:H
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2032
Practice Address - Country:US
Practice Address - Phone:727-787-3911
Practice Address - Fax:727-724-1740
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3866111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU1891ZMedicare ID - Type Unspecified
FLU19708Medicare UPIN