Healthcare Provider Details

I. General information

NPI: 1033169669
Provider Name (Legal Business Name): MICHAEL JOHN PARSONS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 12/31/2020
Certification Date: 12/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 PALM COAST PKWY NE
PALM COAST FL
32137-3886
US

IV. Provider business mailing address

799 TERRY LN
CLARKSBURG WV
26301-6677
US

V. Phone/Fax

Practice location:
  • Phone: 386-445-7073
  • Fax:
Mailing address:
  • Phone: 304-698-5113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19645
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: