Provider Demographics
NPI:1629303060
Name:PARSONS FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:PARSONS FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-478-8787
Mailing Address - Street 1:PO BOX 2530
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-2530
Mailing Address - Country:US
Mailing Address - Phone:606-478-8787
Mailing Address - Fax:606-478-4801
Practice Address - Street 1:24 LEFT PENHOOK RD
Practice Address - Street 2:
Practice Address - City:HAROLD
Practice Address - State:KY
Practice Address - Zip Code:41635-7001
Practice Address - Country:US
Practice Address - Phone:606-478-8787
Practice Address - Fax:606-478-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY42142261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1457522724OtherERNEST BREWER NPI NUMBER
KY1710160882OtherNATHAN BRICKEN NPI NUMBER
KY7100055110Medicaid