1366755910 NPI number — MRS. MARGARET H PARKER PT

Table of content: MRS. MARGARET H PARKER PT (NPI 1366755910)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366755910 NPI number — MRS. MARGARET H PARKER PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARKER
Provider First Name:
MARGARET
Provider Middle Name:
H
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARPER
Provider Other First Name:
MARGARET
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1366755910
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1242 ANCHOR DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOBILE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36693-4500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-583-7753
Provider Business Mailing Address Fax Number:
757-689-4381

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1242 ANCHOR DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36693-4500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-583-7753
Provider Business Practice Location Address Fax Number:
757-689-4381
Provider Enumeration Date:
07/23/2010

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: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: PTH3817 . This is a "STATE LICENSE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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