Provider Demographics
NPI:1528072352
Name:PARROTT, LILBOURN L SR (MD)
Entity type:Individual
Prefix:
First Name:LILBOURN
Middle Name:L
Last Name:PARROTT
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LILBOURN
Other - Middle Name:L
Other - Last Name:PARROTT
Other - Suffix:SR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:800 WALNUT ST
Mailing Address - Street 2:12TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:215-829-8000
Mailing Address - Fax:215-829-8623
Practice Address - Street 1:800 WALNUT ST
Practice Address - Street 2:12TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:215-829-8000
Practice Address - Fax:215-829-8623
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016456E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010796310009Medicaid
PA0010796310009Medicaid
PA159430Medicare PIN