Provider Demographics
NPI:1699899690
Name:PARKINSON, JEFFERY DAVID (MA DABNM)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:DAVID
Last Name:PARKINSON
Suffix:
Gender:M
Credentials:MA DABNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13861 SINGLE LEAF CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-2969
Mailing Address - Country:US
Mailing Address - Phone:719-375-3150
Mailing Address - Fax:888-460-8553
Practice Address - Street 1:13861 SINGLE LEAF CT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-2969
Practice Address - Country:US
Practice Address - Phone:719-375-3150
Practice Address - Fax:888-460-8553
Is Sole Proprietor?:No
Enumeration Date:2007-03-17
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CO291231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No174400000XOther Service ProvidersSpecialist