Basic Information
| Provider Information | |||||||||
| NPI: | 1629424429 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FARTHING | ||||||||
| FirstName: | KEVIN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 432 | ||||||||
| Address2: | |||||||||
| City: | PIKEVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 415020432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064302225 | ||||||||
| FaxNumber: | 6068868176 | ||||||||
| Practice Location | |||||||||
| Address1: | 723 S LAKE DR | ||||||||
| Address2: | |||||||||
| City: | PRESTONSBURG | ||||||||
| State: | KY | ||||||||
| PostalCode: | 416531340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064302225 | ||||||||
| FaxNumber: | 6068861986 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2016 | ||||||||
| LastUpdateDate: | 09/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 04367 | KY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.