Provider Demographics
NPI:1831465095
Name:FARNHAM, GARY STEVAN (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:STEVAN
Last Name:FARNHAM
Suffix:
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 1:210 PILOT VIEW RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-9647
Mailing Address - Country:US
Mailing Address - Phone:541-482-8588
Mailing Address - Fax:
Practice Address - Street 1:210 PILOT VIEW RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-9647
Practice Address - Country:US
Practice Address - Phone:541-482-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-31
Last Update Date:2012-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications