MEDICARE: DR. ALMA L PARKER II M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	037640	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164474037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALMA L PARKER II M.D.

Provider Business Mailing Address
First Line	:	175 N 100 W
Second Line	:	SUITE 205
City	:	VERNAL
State	:	UT
Zip	:	84078-2049
Country	:	US
Telephone Number	:	435-781-6300
Fax Number	:	435-781-6301

Provider Business Practice Location Address
First Line	:	175 N 100 W
Second Line	:	SUITE 205
City	:	VERNAL
State	:	UT
Zip	:	84078-2049
Country	:	US
Telephone Number	:	435-781-6300
Fax Number	:	435-781-6301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	10/01/2010

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