Basic Information
| Provider Information | |||||||||
| NPI: | 1629303060 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARSONS FAMILY MEDICINE PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2530 | ||||||||
| Address2: | |||||||||
| City: | PIKEVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 415022530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064788787 | ||||||||
| FaxNumber: | 6064784801 | ||||||||
| Practice Location | |||||||||
| Address1: | 24 LEFT PENHOOK RD | ||||||||
| Address2: | |||||||||
| City: | HAROLD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 416357001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064788787 | ||||||||
| FaxNumber: | 6064784801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2009 | ||||||||
| LastUpdateDate: | 03/26/2010 | ||||||||
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| AuthorizedOfficialLastName: | PARSONS | ||||||||
| AuthorizedOfficialFirstName: | JEREMY | ||||||||
| AuthorizedOfficialMiddleName: | CRAIG | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 6064788787 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0100X | 42142 | KY | Y | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
ID Information
| ID | Type | State | Issuer | Description | 1457522724 | 01 | KY | ERNEST BREWER NPI NUMBER | OTHER | 1710160882 | 01 | KY | NATHAN BRICKEN NPI NUMBER | OTHER | 7100055110 | 05 | KY | MEDICAID |