1376652032 NPI number — W M PARKER,PC

Table of content: (NPI 1376652032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376652032 NPI number — W M PARKER,PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
W M PARKER,PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WILLIAM PARKER,MD OR MARY R PARKER,MD
Provider Other Organization Name Type Code:
3
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:
1376652032
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 108810
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73101-8810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-223-3216
Provider Business Mailing Address Fax Number:
580-223-4184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2002 12TH AVE NW
Provider Second Line Business Practice Location Address:
STE E
Provider Business Practice Location Address City Name:
ARDMORE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73401-1227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-223-3216
Provider Business Practice Location Address Fax Number:
580-223-4184
Provider Enumeration Date:
08/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PARKER
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
580-223-3216

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X , with the licence number:  21547 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 21534 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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