Provider Demographics
NPI:1750434577
Name:FARNSWORTH, DAVID D (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:D
Last Name:FARNSWORTH
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 1:2121 N 1700 W
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-8803
Mailing Address - Country:US
Mailing Address - Phone:801-773-2970
Mailing Address - Fax:
Practice Address - Street 1:2038 W 1900 S
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:UT
Practice Address - Zip Code:84075-9320
Practice Address - Country:US
Practice Address - Phone:801-773-2970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01063900A207Q00000X
UT98604271205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine