Provider Demographics
NPI:1821053562
Name:FARR, DEREK JAMES (DO)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:JAMES
Last Name:FARR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9074
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-9074
Mailing Address - Country:US
Mailing Address - Phone:352-369-1099
Mailing Address - Fax:352-369-0299
Practice Address - Street 1:2640 SW 32ND PL
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7847
Practice Address - Country:US
Practice Address - Phone:352-369-1099
Practice Address - Fax:352-369-0299
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9484207X00000X
FLOS009484207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1306905948OtherNPI GROUP
FL1306905948OtherNPI GROUP
FLI48997Medicare UPIN
FL5929150001Medicare NSC
FLAA032Medicare PIN
FL16973YMedicare PIN