Provider Demographics
NPI:1578452413
Name:GLENN R. PARRIS, MD PC
Entity type:Organization
Organization Name:GLENN R. PARRIS, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-JACQUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-210-5225
Mailing Address - Street 1:PO BOX 1519
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30048-1519
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5271 LAWRENCEVILLE HWY NW STE A
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-5922
Practice Address - Country:US
Practice Address - Phone:770-962-1616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLENN R. PARRIS, MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty