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General NPI Number Information
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NPI Number | 1265745830
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Entity Type | Organization
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Legal Business Name | DENNIS R PARKER, D.O. LTD
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Dates
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Enumeration Date | 07/23/2010
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Last Update Date | 07/23/2010
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Provider Practice Location Address
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Address Line | 4350 N 19TH AVE #1
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City | PHOENIX
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State | AZ
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Zip | 85015-4602
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Country | US
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Telephone | 602-264-4848
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Fax | 602-264-4145
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Provider Business Mailing Address
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Address Line | 4350 N 19TH AVE #1
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City | PHOENIX
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State | AZ
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Zip | 85015-4602
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Country | US
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Telephone | 602-264-4848
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Fax | 602-264-4145
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DENNIS R PARKER
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Credential | D.O.
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Telephone | 602-264-4848
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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 | 0819
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License Number State | AZ
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