Healthcare Provider Details

I. General information

NPI: 1538171350
Provider Name (Legal Business Name): PARISH A. MCKINNEY MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3817 LAWNDALE DR STE D
GREENSBORO NC
27455-1641
US

IV. Provider business mailing address

3817 LAWNDALE DR STE D
GREENSBORO NC
27455-1641
US

V. Phone/Fax

Practice location:
  • Phone: 336-282-1251
  • Fax: 336-282-1252
Mailing address:
  • Phone: 336-282-1251
  • Fax: 336-282-1252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9700664
License Number StateNC

VIII. Authorized Official

Name: DR. PARISH ANN MCKINNEY
Title or Position: PRESIDENT/PSYCHIATRIST
Credential: M.D.
Phone: 336-282-1251