Provider Demographics
NPI:1427201979
Name:PARSONS, DORA BETH (PA-C)
Entity Type:Individual
Prefix:
First Name:DORA BETH
Middle Name:
Last Name:PARSONS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 PHAY AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-2334
Mailing Address - Country:US
Mailing Address - Phone:719-276-2222
Mailing Address - Fax:719-276-9199
Practice Address - Street 1:1335 PHAY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2334
Practice Address - Country:US
Practice Address - Phone:719-276-2222
Practice Address - Fax:719-276-9199
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO989363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant