MEDICARE: PARISH A. MCKINNEY MD PA

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	2084P0800X	Psychiatry Physician	9700664	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1152041	OTHER	NC	UNITED BEHAVIORAL HEALTH
2	11284	OTHER	NC	BCBS
3	74112	OTHER	NC	MEDCOST

General Provider Information

NPI Number	:	1538171350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARISH A. MCKINNEY MD PA

Provider Business Mailing Address
First Line	:	3817 LAWNDALE DR STE D
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-1641
Country	:	US
Telephone Number	:	336-282-1251
Fax Number	:	336-282-1252

Provider Business Practice Location Address
First Line	:	3817 LAWNDALE DR STE D
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-1641
Country	:	US
Telephone Number	:	336-282-1251
Fax Number	:	336-282-1252

Authorized Official
Title or Position	:	PRESIDENT/PSYCHIATRIST
Name	:	DR. PARISH ANN MCKINNEY
Credential	:	M.D.
Telephone Number	:	336-282-1251

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	08/22/2020

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