Provider Demographics
NPI:1497858831
Name:PARSONS, SUSAN R (DO)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:R
Last Name:PARSONS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9550 ZIONSVILLE RD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1065
Mailing Address - Country:US
Mailing Address - Phone:317-872-0116
Mailing Address - Fax:317-874-1440
Practice Address - Street 1:1616 EASTPORT PLAZA DR
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-6128
Practice Address - Country:US
Practice Address - Phone:317-872-0116
Practice Address - Fax:317-874-1440
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1100334OtherUHC MEDICARE COMPLETE
G60834OtherMERCY HEALTH PLAN
IL253187OtherHARMONY HEALTH
5811655OtherAETNA
1100334OtherUHC MEDICARE COMPLETE
G60834Medicare UPIN
ILL82459Medicare PIN
ILK49676Medicare PIN