Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 20797 | KY |
N | 208D00000X | General Practice Physician | 20797 | KY |
NPI | 1033167440 |
---|---|
Provider Name | Charles W Parrish |
First Address | London, KY 40743-0936 |
Second Address | Bardstown, KY 40004-9094 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 22/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000477568 | ANTHEM BCBS (01) | |
1230089 | CHA (01) | |
50012022 | PASSPORT (01) | |
64207970 | (05) | KY |
966353 | FIRST HEALTH (01) | |
C67012 | (02) |