Provider Demographics
NPI:1821196403
Name:PARSONS, MARSHAL RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARSHAL
Middle Name:RAY
Last Name:PARSONS
Suffix:
Gender:M
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:PO BOX 601529
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 BILLINGSLEY RD STE 105
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1084
Practice Address - Country:US
Practice Address - Phone:704-384-4098
Practice Address - Fax:704-384-4173
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30222208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8965682Medicaid
NY65682OtherBLUE CROSS BLUE SHIELD #
SCN30222OtherSC MEDICAID #
NC8965682Medicaid