Parkside Eye Clinic P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4301036386 Issued in MI

Legal business name

PARKSIDE EYE CLINIC P.C.

Practice address

2108 Fourth Street
Jackson, MI 49203-4518

Phone

(517) 787-8443

Fax

(517) 787-0701

NPI assigned

Oct 18, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ghulam Dastgir

Title

President

Phone

(517) 787-8443

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1861777161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 FOURTH STREET",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492034518",
            "telephone_number": "517-787-8443",
            "fax_number": "517-787-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 FOURTH STREET",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492034518",
            "telephone_number": "517-787-8443",
            "fax_number": "517-787-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE EYE CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "DASTGIR",
        "authorized_official_first_name": "GHULAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-787-8443"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301036386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Parisian, M.D
• Susan H Park, LMSW
• Yung I Park, M.D.
• Carrie L Parker, MOT, OTRL
• Zahira Parker
• Parkside Pediatric Clinic,P.C.
• Andrew Parrow
• Rebecca R Parrow, PHARMD, BCOP
• Meghan Renee Parsons, LLMSW
• Taylor Dale Parsons, PTA

• Ophthalmology Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.