Provider Demographics
NPI:1992990311
Name:PARRISH, CHAD ALLEN (PA)
Entity type:Individual
Prefix:MR
First Name:CHAD
Middle Name:ALLEN
Last Name:PARRISH
Suffix:
Gender:M
Credentials:PA
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 909
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:UT
Mailing Address - Zip Code:84653-0909
Mailing Address - Country:US
Mailing Address - Phone:801-477-9007
Mailing Address - Fax:801-477-9006
Practice Address - Street 1:118 N MAIN ST
Practice Address - Street 2:STE B
Practice Address - City:SALEM
Practice Address - State:UT
Practice Address - Zip Code:84653-5698
Practice Address - Country:US
Practice Address - Phone:801-477-9007
Practice Address - Fax:801-477-9006
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1992990311Medicaid
UT1992990311Medicaid