Provider Demographics
NPI:1700184678
Name:PARSONS, RYAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:J
Last Name:PARSONS
Suffix:
Gender:M
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 741171
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80006-1171
Mailing Address - Country:US
Mailing Address - Phone:303-456-5689
Mailing Address - Fax:303-421-2358
Practice Address - Street 1:11803 W 84TH PL
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-5183
Practice Address - Country:US
Practice Address - Phone:303-456-5689
Practice Address - Fax:303-421-2358
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO025523OtherKAISER COMMERCIAL NUMBER
CO13559079Medicaid
CO025523OtherKAISER COMMERCIAL NUMBER