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General NPI Number Information
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NPI Number | 1255370003
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Entity Type | Individual
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Provider Name | DAVID GLENN PARKER MD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 04/11/2018
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Provider Practice Location Address
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Address Line | 1020 TERRACE DR SUITE 200
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City | MARION
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State | VA
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Zip | 24354-4392
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Country | US
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Telephone | 276-783-7167
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Fax | 276-783-6716
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Provider Business Mailing Address
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Address Line | 1048 TERRACE DR
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City | MARION
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State | VA
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Zip | 24354-4138
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Country | US
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Telephone | 276-783-1827
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Fax | 276-783-2879
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102201854
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License Number State | VA
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