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General NPI Number Information
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NPI Number | 1457267486
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Entity Type | Individual
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Provider Name | BLAINE H PARKER DR.
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Gender | Male
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 1169 EASTERN PKWY STE 3353
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City | LOUISVILLE
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State | KY
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Zip | 40217-1415
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Country | US
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Telephone | 502-309-2408
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Fax |
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Provider Business Mailing Address
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Address Line | 1169 EASTERN PKWY # 1415
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City | LOUISVILLE
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State | KY
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Zip | 40217-1417
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Country | US
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Telephone | 502-309-2408
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 304755
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License Number State | KY
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