Healthcare Provider Details

I. General information

NPI: 1912005877
Provider Name (Legal Business Name): ROBERT BARBOUR PARKER PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 JEFFERSON AVE
MEMPHIS TN
38104-2127
US

IV. Provider business mailing address

8515 SPRUCE TREE CV
CORDOVA TN
38018-7370
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-7143
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number08717
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: