Healthcare Provider Details

I. General information

NPI: 1114509684
Provider Name (Legal Business Name): RONALD PARKINSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2021
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 E CHANDLER BLVD STE 104
PHOENIX AZ
85048-7647
US

IV. Provider business mailing address

PO BOX 33269
PHOENIX AZ
85067-3269
US

V. Phone/Fax

Practice location:
  • Phone: 480-728-4400
  • Fax: 480-728-4411
Mailing address:
  • Phone: 604-406-4786
  • Fax: 916-636-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number010209
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: