Provider Demographics
NPI:1740303098
Name:PARRISH, BEN DEAL (OD)
Entity type:Individual
Prefix:DR
First Name:BEN
Middle Name:DEAL
Last Name:PARRISH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WILLOW CREEK LN.L
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659
Mailing Address - Country:US
Mailing Address - Phone:423-741-4554
Mailing Address - Fax:
Practice Address - Street 1:102 VILLAGE SQUARE LN
Practice Address - Street 2:UNIT B
Practice Address - City:MOUNTAIN CITY
Practice Address - State:TN
Practice Address - Zip Code:37683-1886
Practice Address - Country:US
Practice Address - Phone:423-727-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD371152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist