Provider Demographics
NPI:1134290778
Name:ROBERT J. PAREL II MD LLC
Entity Type:Organization
Organization Name:ROBERT J. PAREL II MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBER
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAREL
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:478-745-0711
Mailing Address - Street 1:PO BOX 4048
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31208-4048
Mailing Address - Country:US
Mailing Address - Phone:478-745-0711
Mailing Address - Fax:478-745-9639
Practice Address - Street 1:380 HOSPITAL DR
Practice Address - Street 2:BLDG A SUITE 370
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-8001
Practice Address - Country:US
Practice Address - Phone:478-745-0711
Practice Address - Fax:478-745-9639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADE0057OtherRAIL ROAD MEDICARE GROUP
GAGRP7199Medicare ID - Type UnspecifiedMEDICARE GROUP #