Healthcare Provider Details

I. General information

NPI: 1447469135
Provider Name (Legal Business Name): ALTON PARKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4465 S MATHEWS WAY
SALT LAKE CITY UT
84124-4027
US

IV. Provider business mailing address

PO BOX 3998
JACKSON WY
83001-3998
US

V. Phone/Fax

Practice location:
  • Phone: 307-690-8690
  • Fax:
Mailing address:
  • Phone: 307-690-8690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number8454A
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number8454A
License Number StateWY
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number8454A
License Number StateWY
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number8454A
License Number StateWY
# 5
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number8454A
License Number StateWY
# 6
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number8454A
License Number StateWY
# 7
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number8454A
License Number StateWY
# 8
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number4301084487
License Number StateMI
# 9
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number8454A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: