1497858807 NPI number — DR. WOODROW MCCLAIN PARKER PHD

Table of content: DR. WOODROW MCCLAIN PARKER PHD (NPI 1497858807)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497858807 NPI number — DR. WOODROW MCCLAIN PARKER PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARKER
Provider First Name:
WOODROW
Provider Middle Name:
MCCLAIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
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:
1497858807
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5426 NW 48TH PLACE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GAINESVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-373-6171
Provider Business Mailing Address Fax Number:
352-846-1030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 FLETCHER DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32611-7500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-392-1161
Provider Business Practice Location Address Fax Number:
352-846-1030
Provider Enumeration Date:
09/07/2006

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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