=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649290321
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT LYDON PARRY MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2006
-----------------------------------------------------
Last Update Date | 09/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 MANNING DR
-----------------------------------------------------
City | CHAPEL HILL
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27514-4220
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 984-974-1000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 PERKINS SQ
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44308-1063
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-543-6060
-----------------------------------------------------
Fax | 330-543-6069
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0120X
-----------------------------------------------------
Taxonomy Name | Pediatric Surgery Physician
-----------------------------------------------------
License Number | E-18184
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 2023-02730
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | E-18184
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 2086S0120X
-----------------------------------------------------
Taxonomy Name | Pediatric Surgery Physician
-----------------------------------------------------
License Number | 35-080742
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------