Basic Information
Provider Information
NPI: 1396128179
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARMELEE
FirstName: JOSHUA
MiddleName: K
NamePrefix: MR.
NameSuffix:  
Credential: OD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1950 OLD GALLOWS RD
Address2: SUITE 520
City: VIENNA
State: VA
PostalCode: 221823990
CountryCode: US
TelephoneNumber: 7038478899
FaxNumber: 7039910514
Practice Location
Address1: 2215 MEMORIAL DR
Address2:  
City: WAYCROSS
State: GA
PostalCode: 315010983
CountryCode: US
TelephoneNumber: 9122852021
FaxNumber: 9122852558
Other Information
ProviderEnumerationDate: 06/30/2015
LastUpdateDate: 02/16/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000XOPT002879GAY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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