Provider Demographics
NPI:1841281490
Name:PARSIOLA, CHARLES RAYMOND (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:RAYMOND
Last Name:PARSIOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:CHARENTON
Mailing Address - State:LA
Mailing Address - Zip Code:70523-0640
Mailing Address - Country:US
Mailing Address - Phone:337-923-9955
Mailing Address - Fax:337-923-7791
Practice Address - Street 1:3231 CHITIMACHA TRAIL
Practice Address - Street 2:
Practice Address - City:CHARENTON
Practice Address - State:LA
Practice Address - Zip Code:70523
Practice Address - Country:US
Practice Address - Phone:337-923-9955
Practice Address - Fax:337-923-7791
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12053R207Q00000X, 207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ING18352Medicare UPIN