Provider Demographics
NPI:1013218080
Name:DOTY, PARKER JAMES
Entity Type:Individual
Prefix:MR
First Name:PARKER
Middle Name:JAMES
Last Name:DOTY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 COLLINS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3352
Mailing Address - Country:US
Mailing Address - Phone:304-598-2909
Mailing Address - Fax:724-941-1787
Practice Address - Street 1:3142 COLLINS FERRY RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3352
Practice Address - Country:US
Practice Address - Phone:304-598-2909
Practice Address - Fax:724-941-1787
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician