Provider Demographics
NPI:1982925228
Name:JOHN R. PARNELL M.D., P.A.
Entity Type:Organization
Organization Name:JOHN R. PARNELL M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSNESS MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:C
Authorized Official - Last Name:PARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-252-5501
Mailing Address - Street 1:647 ORANGE AVE.
Mailing Address - Street 2:STE A
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114
Mailing Address - Country:US
Mailing Address - Phone:386-252-5501
Mailing Address - Fax:386-258-8483
Practice Address - Street 1:647 ORANGE AVE.
Practice Address - Street 2:STE A
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114
Practice Address - Country:US
Practice Address - Phone:386-252-5501
Practice Address - Fax:386-258-8483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME11290173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty