1609871102 NPI number — MS. SUE MAJOR PARKINS M.D.

Table of content: MS. SUE MAJOR PARKINS M.D. (NPI 1609871102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609871102 NPI number — MS. SUE MAJOR PARKINS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARKINS
Provider First Name:
SUE
Provider Middle Name:
MAJOR
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CAMERON
Provider Other First Name:
SUE
Provider Other Middle Name:
PARKINS
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1609871102
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26357 CARRINGTON BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PERRYSBURG
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43551-9546
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-872-2220
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2213 CHERRY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43608-2603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-251-4634
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  35040976 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 35040976 . This is a "OHIO LICENSE NUMBER" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0517328 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2083X0100X . This is a "TAXONOMY CODE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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