Healthcare Provider Details

I. General information

NPI: 1366357014
Provider Name (Legal Business Name): DR. PARKER TEE FOWLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 SILAS CREEK PKWY
WINSTON SALEM NC
27103-3013
US

IV. Provider business mailing address

539 POWER PLANT CIR APT 224
WINSTON SALEM NC
27101-4194
US

V. Phone/Fax

Practice location:
  • Phone: 336-718-5000
  • Fax:
Mailing address:
  • Phone: 704-773-9124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34907
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: