Provider Demographics
NPI:1043262223
Name:PARSLEY, DEIDRE E (DO)
Entity type:Individual
Prefix:
First Name:DEIDRE
Middle Name:E
Last Name:PARSLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1958
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:WV
Mailing Address - Zip Code:25661-1958
Mailing Address - Country:US
Mailing Address - Phone:304-235-2930
Mailing Address - Fax:304-235-2933
Practice Address - Street 1:2900 FIRST AVENUE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702
Practice Address - Country:US
Practice Address - Phone:304-399-7484
Practice Address - Fax:304-399-7579
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2060207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV107376OtherBRICKSTREET
WV3810000626Medicaid
WV7800765OtherCIGNA
WV2177885OtherUHC
OH000000245867OtherUNISON
KY64065246Medicaid
WV7800765OtherCIGNA
WVP00687531Medicare PIN
WV3810000626Medicaid
KY64065246Medicaid