1538171350 NPI number — PARISH A. MCKINNEY MD PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538171350 NPI number — PARISH A. MCKINNEY MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARISH A. MCKINNEY MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1538171350
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3817 LAWNDALE DR STE D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27455-1641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-282-1251
Provider Business Mailing Address Fax Number:
336-282-1252

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3817 LAWNDALE DR STE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27455-1641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-282-1251
Provider Business Practice Location Address Fax Number:
336-282-1252
Provider Enumeration Date:
08/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCKINNEY
Authorized Official First Name:
PARISH
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
PRESIDENT/PSYCHIATRIST
Authorized Official Telephone Number:
336-282-1251

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  9700664 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1152041 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 11284 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 74112 . This is a "MEDCOST" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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