Provider Demographics
NPI:1063483071
Name:PARSONS, MATTHEW REED (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:REED
Last Name:PARSONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-1010
Mailing Address - Country:US
Mailing Address - Phone:801-374-1818
Mailing Address - Fax:801-374-0163
Practice Address - Street 1:1735 N STATE ST
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-1010
Practice Address - Country:US
Practice Address - Phone:801-374-1818
Practice Address - Fax:801-379-2959
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT901823741205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTQM0000024029OtherALTIUS
UT87028357684604A001OtherTRICARE
UT0800053OtherUNITED HEALTHCARE
UT107006748102OtherSELECT HEALTH
UT220419OtherDMBA
UT870283576PA1OtherEMIA
UT9662901004OtherCIGNA
UT4625744OtherAETNA
UT4625744OtherAETNA
UT000011448Medicare ID - Type Unspecified