1043262223 NPI number — DEIDRE E PARSLEY DO

Table of content: DEIDRE E PARSLEY DO (NPI 1043262223)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043262223 NPI number — DEIDRE E PARSLEY DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARSLEY
Provider First Name:
DEIDRE
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043262223
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1958
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25661-1958
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-235-2930
Provider Business Mailing Address Fax Number:
304-235-2933

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 FIRST AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-399-7484
Provider Business Practice Location Address Fax Number:
304-399-7579
Provider Enumeration Date:
05/16/2006

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: 207Q00000X , with the licence number:  2060 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 107376 . This is a "BRICKSTREET" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 3810000626 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7800765 . This is a "CIGNA" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 2177885 . This is a "UHC" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 000000245867 . This is a "UNISON" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 64065246 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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