Provider Demographics
NPI:1164646238
Name:PARRISH, CHARLES ANDREW
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ANDREW
Last Name:PARRISH
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 1:1010 AIRPARK CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-5200
Mailing Address - Country:US
Mailing Address - Phone:615-221-4400
Mailing Address - Fax:
Practice Address - Street 1:3918 MONTCLAIR RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35213-2425
Practice Address - Country:US
Practice Address - Phone:205-705-3550
Practice Address - Fax:205-705-3554
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100324207ND0900X
TXM4422207ND0900X
GA060139207ND0900X
TN42811207ND0900X
CO49736207ND0900X
NJ25MA08890200207ND0900X
NY2592211207ND0900X
CAA109974207ND0900X
VA0101245568207ND0900X
SC31499207ND0900X
ARE5954207ND0900X
NC200800367207ND0900X
MS21341207ND0900X
LAMD.201881207ND0900X
AL25063207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51136307OtherBLUE CROSS
103I221524Medicare PIN