Bradley A Farlow, O.D.
Individual provider Active NPI Corneal and Contact Management Optometrist · Wabash, IN
NPI 1821077124 · NPPES record last updated Sep 4, 2009
Key facts
- NPI
- 1821077124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Corneal and Contact Management Optometrist 152WC0802X
- License
- 18002054A (IN)
- Practice address
- 144 W Hill St
Wabash, IN 46992-3048 - Phone
- (260) 563-2020
- Fax
- (260) 563-2873
- NPI assigned
- Jan 13, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18002054A | IN | MD | Corneal and Contact Management Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 18002054A | IN | Yes |
| Optometrist | 152W00000X | 18002054A | IN | |
| Occupational Vision Optometrist | 152WX0102X | 18002054A | IN | |
| Pediatric Optometrist | 152WP0200X | 18002054A | IN | |
| Sports Vision Optometrist | 152WS0006X | 18002054A | IN |
Addresses
Primary practice location
144 W Hill St
Wabash, IN 46992-3048
Mailing address
PO Box 647
Wabash, IN 46992-0647
Phone (260) 563-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100253500B | Medicaid | IN | |
| 000000088323 | Other | IN | ANTHEM BLUE CROSS & SHIEL |
| 134927 | Other | IN | EYEMED VISION CARE |
Other providers in Wabash, IN
- Jessica Engels
- Nicole R Enslen
- Family Chiropractic PC
- Family Physicians Associated
- Farlow Enterprises, Inc.
- Stephen Fassino
- Kelsey Ferguson
- Elizabeth L. Finicle
- Foreman Care Corp
- Fort Wayne Taxi LLC
All providers in Wabash, IN · Corneal and Contact Management Optometrist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.