Healthcare Provider Details

I. General information

NPI: 1194757187
Provider Name (Legal Business Name): JACQUELINE CHERIE PARKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LAWN AVENUE GRANDVIEW HOSPITAL
SELLERSVILLE PA
18960
US

IV. Provider business mailing address

PO BOX 13700 1432 GRAND VIEW EMERGENCY MEDICINE ASSOCIATES
PHILADELPHIA PA
19191-1432
US

V. Phone/Fax

Practice location:
  • Phone: 215-453-4000
  • Fax: 610-617-6280
Mailing address:
  • Phone: 800-666-2455
  • Fax: 610-617-6280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD044026L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: