Provider Demographics
NPI:1720477938
Name:PARHAM, DOUGLAS F (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:F
Last Name:PARHAM
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2438 N RUTLAND CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1133
Mailing Address - Country:US
Mailing Address - Phone:901-626-4579
Mailing Address - Fax:
Practice Address - Street 1:2438 N RUTLAND CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-1133
Practice Address - Country:US
Practice Address - Phone:901-626-4579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2905235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist