Provider Demographics
NPI:1679794010
Name:PARR, THOMAS GERARD (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GERARD
Last Name:PARR
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 1:2528 SHELBYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-9152
Mailing Address - Country:US
Mailing Address - Phone:502-647-1601
Mailing Address - Fax:
Practice Address - Street 1:2528 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-9152
Practice Address - Country:US
Practice Address - Phone:502-647-1601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4200111N00000X
SC1759111N00000X
HI640111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
6069301Medicare ID - Type Unspecified