Provider Demographics
NPI:1629177415
Name:ANTHONY V. PARKINSON, D.C., LLC
Entity Type:Organization
Organization Name:ANTHONY V. PARKINSON, D.C., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:PARKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:601-899-3167
Mailing Address - Street 1:5903 RIDGEWOOD RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-3700
Mailing Address - Country:US
Mailing Address - Phone:601-899-3167
Mailing Address - Fax:601-899-3914
Practice Address - Street 1:5903 RIDGEWOOD RD
Practice Address - Street 2:SUITE 103
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-3700
Practice Address - Country:US
Practice Address - Phone:601-899-3167
Practice Address - Fax:601-899-3914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00601071Medicaid
MS00119654Medicaid
MS350000313Medicare ID - Type Unspecified
MS00601071Medicaid