Provider Demographics
NPI:1942238746
Name:FARROW, JEFF R (MD)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:R
Last Name:FARROW
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 1:310 N STATE OF FRANKLIN ROAD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6051
Mailing Address - Country:US
Mailing Address - Phone:423-926-8181
Mailing Address - Fax:423-926-8652
Practice Address - Street 1:310 N STATE OF FRANKLIN ROAD
Practice Address - Street 2:SUITE 303
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6051
Practice Address - Country:US
Practice Address - Phone:423-926-8181
Practice Address - Fax:423-926-8652
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20446207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3051126Medicaid
TNC65382Medicare UPIN
TN3051128Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER