Provider Demographics
NPI:1073717229
Name:ALLERGY & ASTHMA ASSOCIATES
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:937-431-0721
Mailing Address - Street 1:2359 LAKEVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3695
Mailing Address - Country:US
Mailing Address - Phone:937-431-0721
Mailing Address - Fax:937-431-5419
Practice Address - Street 1:2359 LAKEVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:BEAVER CREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3695
Practice Address - Country:US
Practice Address - Phone:937-431-0721
Practice Address - Fax:937-431-5419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2493430Medicaid
OHAL9342782Medicare PIN