Provider Demographics
NPI:1255365383
Name:CLASSEN, CAROLYN FARLEY (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:FARLEY
Last Name:CLASSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2700 LUTHER DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-8131
Mailing Address - Country:US
Mailing Address - Phone:717-217-3523
Mailing Address - Fax:717-264-0947
Practice Address - Street 1:2700 LUTHER DR
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-8131
Practice Address - Country:US
Practice Address - Phone:717-217-3523
Practice Address - Fax:717-264-0947
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045478L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF13130Medicare UPIN