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General NPI Number Information
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NPI Number | 1255397147
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Entity Type | Individual
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Provider Name | JEFFERY DEAN PARSON C.O.
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Gender | Male
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 1619 JOHN ORR DRIVE
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City | TIFTON
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State | GA
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Zip | 31794-3640
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Country | US
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Telephone | 229-386-9829
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Fax | 229-386-9830
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Provider Business Mailing Address
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Address Line | 1619 JOHN ORR DR
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City | TIFTON
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State | GA
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Zip | 31794-3640
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Country | US
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Telephone | 229-386-9829
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Fax | 229-386-9830
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number | 1415
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License Number State | GA
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