Provider Demographics
NPI:1356422273
Name:PARRY, K A SR (PHD)
Entity type:Individual
Prefix:DR
First Name:K
Middle Name:A
Last Name:PARRY
Suffix:SR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:CHIEF
Other - Middle Name:
Other - Last Name:PARRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 21865
Mailing Address - Street 2:WESTSIDE STATION
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72221-1865
Mailing Address - Country:US
Mailing Address - Phone:501-580-9231
Mailing Address - Fax:
Practice Address - Street 1:4300 WEST SEVENTH STREET
Practice Address - Street 2:CENTRAL ARKANSAS VETERANS HEALTH CARE SYSTEM
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-257-6604
Practice Address - Fax:501-257-6602
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR828P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical