Healthcare Provider Details

I. General information

NPI: 1235332255
Provider Name (Legal Business Name): JENNIFER PARKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER HOBBS M.D.

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 08/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 GARRETT RD
DURHAM NC
27707-3487
US

IV. Provider business mailing address

4300 GARRETT RD
DURHAM NC
27707-3487
US

V. Phone/Fax

Practice location:
  • Phone: 919-407-8223
  • Fax:
Mailing address:
  • Phone: 919-407-8223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number141550
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: