Basic Information
| Provider Information | |||||||||
| NPI: | 1063467397 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARSELL | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | JACKSON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6701 AIRPORT BLVD STE D143 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366086701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2513423949 | ||||||||
| FaxNumber: | 2512663361 | ||||||||
| Practice Location | |||||||||
| Address1: | 6701 AIRPORT BLVD | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2512663580 | ||||||||
| FaxNumber: | 2512663581 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 10/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | ME140829 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | 208M00000X | ME140829 | FL | N | Allopathic & Osteopathic Physicians | Hospitalist | 208000000X | 22843 | AL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 009934493 | 05 | AL | MEDICAID | 1523500 | 05 | LA | MEDICAID | 51532197 | 01 | AL | BLUE CROSS | OTHER | 102I371787 | 01 | AL | MEDICARE PECOS | OTHER | 51599838 | 01 | AL | BLUE CROSS BLUE SHIELD | OTHER | 102I371787 | 01 | MEDICARE PTAN | OTHER | 009936161 | 05 | AL | MEDICAID | 07181063 | 05 | MS | MEDICAID | 100463400 | 05 | FL | MEDICAID | 12-00578 | 01 | AL | UNITED HEALTH CARE | OTHER | 112863 | 05 | AL | MEDICAID |