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NPI 1609427418

NPI 1609427418 : BRYAN THOMAS PARROTT OD : SAINT PAUL, MN

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General NPI Number Information
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    NPI Number           |    1609427418
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    Entity Type          |    Individual 
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    Provider Name        |    BRYAN THOMAS PARROTT OD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/23/2019
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    Last Update Date     |    05/18/2022
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Provider Practice Location Address
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    Address Line         |    2024 FORD PKWY 
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    City                 |    SAINT PAUL
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    State                |    MN
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    Zip                  |    55116-1931
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    Country              |    US
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    Telephone            |    651-698-2020
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    Fax                  |    651-698-6918
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Provider Business Mailing Address
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    Address Line         |    2024 FORD PKWY 
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    City                 |    SAINT PAUL
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    State                |    MN
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    Zip                  |    55116-1992
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    Country              |    US
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    Telephone            |    651-698-2020
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    Fax                  |    651-698-6918
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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        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    18004196A
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    License Number State |    IN
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Taxonomy #2
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    Taxonomy Code        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    3772
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    License Number State |    MN
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