Provider Demographics
NPI:1891825154
Name:FARMER, MARK NEFFLEN (MD)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:NEFFLEN
Last Name:FARMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 S. WASHINGTON ST.
Mailing Address - Street 2:SUITE B
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634
Mailing Address - Country:US
Mailing Address - Phone:337-463-4777
Mailing Address - Fax:337-463-4770
Practice Address - Street 1:5875 BREMO RD
Practice Address - Street 2:SUITE G-11
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1934
Practice Address - Country:US
Practice Address - Phone:804-287-7804
Practice Address - Fax:804-287-7178
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240226207R00000X, 207RH0003X
LAMD206603207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06778OtherGROUP PTAN