Provider Demographics
NPI:1568797652
Name:PARKINSON, DAVID M (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:PARKINSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11820 SOUTH STATE STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7160
Mailing Address - Country:US
Mailing Address - Phone:801-568-0200
Mailing Address - Fax:
Practice Address - Street 1:11820 SOUTH STATE STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7160
Practice Address - Country:US
Practice Address - Phone:801-568-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8343839-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist