Provider Demographics
NPI:1811196991
Name:FARMER, PETER PATRICK JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:PATRICK
Last Name:FARMER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 12TH AVE S
Mailing Address - Street 2:2000
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6615
Mailing Address - Country:US
Mailing Address - Phone:615-942-6637
Mailing Address - Fax:
Practice Address - Street 1:600 12TH AVE S
Practice Address - Street 2:2000
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-6615
Practice Address - Country:US
Practice Address - Phone:615-942-6637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG16643208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA39858Medicare UPIN