Healthcare Provider Details

I. General information

NPI: 1164373361
Provider Name (Legal Business Name): MR. COREY ZMAR PARKER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8044 MONTGOMERY RD STE 700
CINCINNATI OH
45236-2926
US

IV. Provider business mailing address

4962 SHADOW HAWK DR
CINCINNATI OH
45247-6083
US

V. Phone/Fax

Practice location:
  • Phone: 513-372-5071
  • Fax: 513-672-2544
Mailing address:
  • Phone: 513-289-7158
  • Fax: 513-289-7158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: