Provider Demographics
NPI:1336672096
Name:PARISH, DON EDWARD (DO)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:EDWARD
Last Name:PARISH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-6844
Mailing Address - Country:US
Mailing Address - Phone:727-822-3238
Mailing Address - Fax:727-823-1278
Practice Address - Street 1:6801 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-6844
Practice Address - Country:US
Practice Address - Phone:727-822-3238
Practice Address - Fax:727-823-1278
Is Sole Proprietor?:No
Enumeration Date:2017-04-09
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLOS16886207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107935600Medicaid