Provider Demographics
NPI:1508857970
Name:PARRIS, JEANETTE S (MD)
Entity type:Individual
Prefix:MRS
First Name:JEANETTE
Middle Name:S
Last Name:PARRIS
Suffix:
Gender:F
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 68
Mailing Address - Street 2:
Mailing Address - City:S WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-0001
Mailing Address - Country:US
Mailing Address - Phone:781-803-2786
Mailing Address - Fax:781-812-1631
Practice Address - Street 1:10 NEW DRIFTWAY
Practice Address - Street 2:STE 201
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-4530
Practice Address - Country:US
Practice Address - Phone:781-545-9225
Practice Address - Fax:781-545-8560
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78950208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA201006OtherHPHC
355282OtherCIGNA
756268OtherTUFTS
400022OtherTUFTS USFHP
MAPAJ16387OtherBCBS
MA3198812Medicaid
MA201006OtherHPHC
MAPAJ16387OtherBCBS