1093860116 NPI number — MR. RONNIE CHRISTOPHER PARKER DO

Table of content: MR. RONNIE CHRISTOPHER PARKER DO (NPI 1093860116)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093860116 NPI number — MR. RONNIE CHRISTOPHER PARKER DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARKER
Provider First Name:
RONNIE
Provider Middle Name:
CHRISTOPHER
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093860116
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BIG SANDY HEALTH CARE, INC
Provider Second Line Business Mailing Address:
1709 KY RTE 321, STE 3
Provider Business Mailing Address City Name:
PRESTONSBURG
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41653
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-886-8546
Provider Business Mailing Address Fax Number:
606-886-8548

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
136 PARK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREEBURN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41528-8718
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-984-5484
Provider Business Practice Location Address Fax Number:
877-447-0814
Provider Enumeration Date:
01/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  02815 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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