MEDICARE: DR. JOHN PRESTON PARRY M.D., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VE0102X	Reproductive Endocrinology Physician	307178	LA
2	207VE0102X	Reproductive Endocrinology Physician	21655	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093745978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN PRESTON PARRY M.D., M.P.H.

Provider Business Mailing Address
First Line	:	149 FOUNTAINS BLVD
Second Line	:
City	:	MADISON
State	:	MS
Zip	:	39110-6344
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	149 FOUNTAINS BLVD
Second Line	:
City	:	MADISON
State	:	MS
Zip	:	39110-6344
Country	:	US
Telephone Number	:	601-202-4779
Fax Number	:	601-202-4685

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	01/08/2026

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