| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LOYAL SHANE FARLEY | 1659930006 | 2023-08-13 |
Loyal Shane Farley is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1659930006. Registration indicates Loyal Shane Farley is a provider of services with a specialization in Emergency Medicine (Allopathic & Osteopathic Physicians, Emergency Medicine) (All Other Specialties & Provider Types, ) (Emergency Medicine, Allopathic & Osteopathic Physicians) Access to Adult/Geriatric Primary Care Providers (Allopathic & Osteopathic Physicians, General Practice) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, General Practice) (Allopathic & Osteopathic Physicians, General Practice) (General Practice, ) (Primary Care/Family Planning/APRN/PA, ) (General Practice, Allopathic & Osteopathic Physicians)
| Entity Type | Individual |
| Provider Name | Loyal Shane Farley DO |
| Practice Office Address | 950 E BOGARD RD STE 103 WASILLA, AK US |
| Practice Office Telephone | 9073522880 |
| Mailing Address | 307 GRIZZLY TRL HARKER HEIGHTS, TX 765485628 US |
| AMR direct address [] | [email protected] | |
| AMR Direct Address [] | [email protected] |
| Code | Practice | License No State |
|---|---|---|
| 207P00000X | Emergency Medicine Allopathic & Osteopathic Physicians Emergency Medicine All Other Specialties & Provider Types Emergency Medicine Allopathic & Osteopathic Physicians | 192430
AK |
| 208D00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians General PracticeAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians General Practice Allopathic & Osteopathic Physicians General Practice General Practice Primary Care/Family Planning/APRN/PA General Practice Allopathic & Osteopathic Physicians | 192430
AK |