Healthcare Provider Details

I. General information

NPI: 1699927129
Provider Name (Legal Business Name): HARRY LESLIE PARLETTE III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 10/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 TERRELL RD E
CHARLOTTESVILLE VA
22901-2166
US

IV. Provider business mailing address

125 TERRELL RD E
CHARLOTTESVILLE VA
22901-2166
US

V. Phone/Fax

Practice location:
  • Phone: 434-293-4310
  • Fax:
Mailing address:
  • Phone: 434-293-4310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number0101029695
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: