Provider Demographics
NPI:1316964984
Name:PARSONS, PAMELA JO (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:JO
Last Name:PARSONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3837 PLAZA TOWER DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4354
Mailing Address - Country:US
Mailing Address - Phone:225-810-3836
Mailing Address - Fax:225-810-3853
Practice Address - Street 1:3837 PLAZA TOWER DR
Practice Address - Street 2:SUITE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4354
Practice Address - Country:US
Practice Address - Phone:225-810-3836
Practice Address - Fax:225-810-3853
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12903R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1126811Medicaid
F68646Medicare UPIN
5E332Medicare ID - Type Unspecified