Provider Demographics
NPI:1689141475
Name:BRETT B FARR LLC
Entity Type:Organization
Organization Name:BRETT B FARR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:B
Authorized Official - Last Name:FARR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-231-0417
Mailing Address - Street 1:PO BOX 7955
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-7900
Mailing Address - Country:US
Mailing Address - Phone:256-231-0417
Mailing Address - Fax:
Practice Address - Street 1:700 QUINTARD AVE STE A
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-5758
Practice Address - Country:US
Practice Address - Phone:256-231-0417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51209637OtherBLUE CROSS BLUE SHIELD