Provider Demographics
NPI:1851591754
Name:WILLIAM M. PARELL, MD, PSC
Entity Type:Organization
Organization Name:WILLIAM M. PARELL, MD, PSC
Other - Org Name:WILLIAM M. PARELL, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:PARELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-278-0494
Mailing Address - Street 1:2101 NICHOLASVILLE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2517
Mailing Address - Country:US
Mailing Address - Phone:859-278-0494
Mailing Address - Fax:859-275-5086
Practice Address - Street 1:2101 NICHOLASVILLE RD STE 103
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2517
Practice Address - Country:US
Practice Address - Phone:859-278-0494
Practice Address - Fax:859-275-5086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY224736207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64224736Medicaid
KY1364801Medicare PIN
KYC74701Medicare UPIN