Individual
ADDISON ROGER PARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1211 SHERWOOD PARK DR NE STE B, GAINESVILLE, GA 30501
(770) 219-4840
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
0101239683
VA
207RI0200X
Infectious Disease Physician
Primary
71009
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010306213
—
VA
01
—
1000870001
DME PROVIDER
VA
01
—
10010531
OPTIMA
VA
01
—
201185
ANTHEM
VA
01
—
3810006037
WV MEDICAID
VA
01
—
437717
SOUTHERN HEALTH
VA
01
—
P00383382
RAILROAD MEDICARE
VA
Enumeration date
05/28/2006
Last updated
10/23/2020
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