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General NPI Number Information
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NPI Number | 1316692767
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Entity Type | Individual
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Provider Name | ROBERT RYAN PARKER
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Gender | Male
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 1000 YUKON AVE
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City | YUKON
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State | OK
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Zip | 73099-4690
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Country | US
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Telephone | 405-265-3444
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Fax | 405-577-5488
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Provider Business Mailing Address
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Address Line | 109 HALL ST
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City | LEXINGTON
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State | OK
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Zip | 73051-9514
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Country | US
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Telephone | 918-759-8224
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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