Healthcare Provider Details
I. General information
NPI: 1083630750
Provider Name (Legal Business Name): LYNN P. PARKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/14/2006
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
676 S FLOYD ST STE 200
LOUISVILLE KY
40202-1840
US
IV. Provider business mailing address
PO BOX 776347
CHICAGO IL
60677-6347
US
V. Phone/Fax
- Phone: 502-629-4440
- Fax: 502-629-4445
- Phone: 502-588-9490
- Fax: 502-272-5116
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 38911 |
| License Number State | KY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | 38911 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: