Provider Demographics
NPI:1568928950
Name:PARISH, DOROTHY ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ELIZABETH
Last Name:PARISH
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 1:7794 KINGS COLLEGE AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2082
Mailing Address - Country:US
Mailing Address - Phone:727-251-8254
Mailing Address - Fax:
Practice Address - Street 1:880 MADISON AVE STE 4B01
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3409
Practice Address - Country:US
Practice Address - Phone:901-515-9595
Practice Address - Fax:901-515-9878
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4326363AS0400X
FL9112041363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant