Provider Demographics
NPI:1740388867
Name:PARSONS, DEBRA LYNN (MD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:PARSONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 GOFF MOUNTAIN ROAD
Mailing Address - Street 2:SUITE 16
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313
Mailing Address - Country:US
Mailing Address - Phone:304-204-2091
Mailing Address - Fax:304-204-2093
Practice Address - Street 1:314 GOFF MOUNTAIN ROAD
Practice Address - Street 2:SUITE 16
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313
Practice Address - Country:US
Practice Address - Phone:304-204-2091
Practice Address - Fax:304-204-2093
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV18342208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0110513000Medicaid
WV0110513000Medicaid