Healthcare Provider Details

I. General information

NPI: 1245658467
Provider Name (Legal Business Name): JEFFREY SCOTT PARSON RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 04/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11993 PLUM DR
NORTHPORT AL
35475-4741
US

IV. Provider business mailing address

11993 PLUM DR
NORTHPORT AL
35475-4741
US

V. Phone/Fax

Practice location:
  • Phone: 205-331-3335
  • Fax:
Mailing address:
  • Phone: 205-331-3335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number299
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: