Provider Demographics
NPI:1306124532
Name:PARISH, DAVID SHAWN (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SHAWN
Last Name:PARISH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1141
Mailing Address - Street 2:
Mailing Address - City:FORTSON
Mailing Address - State:GA
Mailing Address - Zip Code:31808-1141
Mailing Address - Country:US
Mailing Address - Phone:706-718-3636
Mailing Address - Fax:
Practice Address - Street 1:1062 GA HWY 41 NORTH
Practice Address - Street 2:STE. 6
Practice Address - City:BUENA VISTA
Practice Address - State:GA
Practice Address - Zip Code:31803
Practice Address - Country:US
Practice Address - Phone:706-718-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2023-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALV02652Medicare UPIN
AL051521779PARMedicare PIN