Provider Demographics
NPI:1336121664
Name:PARRY, AMY ELISABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ELISABETH
Last Name:PARRY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2101 LIBERTY DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-7720
Mailing Address - Country:US
Mailing Address - Phone:816-792-1809
Mailing Address - Fax:816-792-9819
Practice Address - Street 1:9 VICTORY DR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1973
Practice Address - Country:US
Practice Address - Phone:816-792-1809
Practice Address - Fax:816-792-1860
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2001005046207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO29240011OtherBCBS
MO29240011OtherBCBS
MO000B025Medicare PIN