Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 42142 | KY |
N | 207Q00000X | Family Doctor | TP164 | KY |
NPI | 1811180409 |
---|---|
Provider Name | Dr. Jeremy Craig Parsons |
First Address | Prestonsburg, KY 41653-0406 |
Second Address | Harold, KY 41635-7064 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2007 |
Last Update Date | 25/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100055110 | (05) | KY |