Provider Demographics
NPI:1972574754
Name:FARMER, JAMES A III (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:FARMER
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1239 ALPINE AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-3170
Mailing Address - Country:US
Mailing Address - Phone:616-459-7664
Mailing Address - Fax:
Practice Address - Street 1:1239 ALPINE AVE NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-3170
Practice Address - Country:US
Practice Address - Phone:616-459-7664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301006934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950D151500OtherBCBS PROVIDER CODE
MI950D151500OtherBCBS PROVIDER CODE
MI0D15150Medicare ID - Type UnspecifiedPROVIDER CODE