Provider Demographics
NPI:1144310954
Name:FARMAN, DOUGLAS PAUL (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:PAUL
Last Name:FARMAN
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 1:1550 COLLEGE ST
Mailing Address - Street 2:A
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31207-1500
Mailing Address - Country:US
Mailing Address - Phone:478-301-5801
Mailing Address - Fax:478-301-5812
Practice Address - Street 1:707 PINE ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2106
Practice Address - Country:US
Practice Address - Phone:478-301-5801
Practice Address - Fax:478-301-5812
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA22755207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00380179DMedicaid
GA00380179DMedicaid
GA29BDCFBMedicare PIN
GA29BDCFBMedicare ID - Type Unspecified