Healthcare Provider Details

I. General information

NPI: 1093745978
Provider Name (Legal Business Name): JOHN PRESTON PARRY M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 FOUNTAINS BLVD
MADISON MS
39110-6344
US

IV. Provider business mailing address

1512 W KIRBY PL
SHREVEPORT LA
71103-3822
US

V. Phone/Fax

Practice location:
  • Phone: 601-202-4779
  • Fax: 601-202-4685
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number307178
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number21655
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: