MEDICARE: MRS. PARIS S FORD OT

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	225X00000X	Occupational Therapist
2	225X00000X	Occupational Therapist	7747	NC

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	1862K	OTHER	NC	BCBS OF NC

General Provider Information

NPI Number	:	1295985471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PARIS S FORD OT

Provider Business Mailing Address
First Line	:	7 CORPORATE CENTER CT STE B
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-3839
Country	:	US
Telephone Number	:	336-967-1649
Fax Number	:	336-276-1728

Provider Business Practice Location Address
First Line	:	7 CORPORATE CENTER CT STE B
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-3839
Country	:	US
Telephone Number	:	336-967-1649
Fax Number	:	336-276-1728

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

Provider Enumeration Date	:	09/24/2008
Last Update Date	:	08/21/2022

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