Provider Demographics
NPI:1609970995
Name:PARSONS EYE CLINIC PA
Entity Type:Organization
Organization Name:PARSONS EYE CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:ROTHSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-421-5900
Mailing Address - Street 1:PO BOX B
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357-0080
Mailing Address - Country:US
Mailing Address - Phone:620-421-5900
Mailing Address - Fax:620-421-4613
Practice Address - Street 1:220 N 32ND ST
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-2226
Practice Address - Country:US
Practice Address - Phone:620-421-5900
Practice Address - Fax:620-421-4613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0416857207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0957980001Medicare NSC