MEDICARE: DR. CHARLIE JOHN PARSONS O. D.

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	152W00000X	Optometrist	OEG000051	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	410000963	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	188640	OTHER	PA	HEALTH AMERICA HEALTH ASSURANCE
2	39776	OTHER	PA	HIGHMARK BLUE SHIELD
3	833045	OTHER	PA	AETNA HMO
5	5187071	OTHER	PA	AETNA PPO
6	01436201	OTHER	PA	CBC

General Provider Information

NPI Number	:	1366440588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLIE JOHN PARSONS O. D.

Provider Business Mailing Address
First Line	:	50 EASTERN AVE
Second Line	:	SUITE 107
City	:	GREENCASTLE
State	:	PA
Zip	:	17225-1100
Country	:	US
Telephone Number	:	717-597-7708
Fax Number	:	717-597-1052

Provider Business Practice Location Address
First Line	:	50 EASTERN AVE
Second Line	:	SUITE 107
City	:	GREENCASTLE
State	:	PA
Zip	:	17225-1100
Country	:	US
Telephone Number	:	717-597-7708
Fax Number	:	717-597-1052

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/13/2009

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Directions to “ DR. CHARLIE JOHN PARSONS O. D.” Practice Location

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