Provider Demographics
NPI:1972645331
Name:PARSICK, STANLEY JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:JOSEPH
Last Name:PARSICK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 HILLTOP WEST SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451
Mailing Address - Country:US
Mailing Address - Phone:757-491-1977
Mailing Address - Fax:757-491-1136
Practice Address - Street 1:612 HILLTOP WEST SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451
Practice Address - Country:US
Practice Address - Phone:757-491-1977
Practice Address - Fax:757-491-1136
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA06180000229152W00000X, 156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No156F00000XEye and Vision Services ProvidersTechnician/Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9231005Medicaid
VAU21986Medicare UPIN
410000902Medicare PIN