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General NPI Number Information
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NPI Number | 1568437739
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Entity Type | Individual
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Provider Name | GLENN S PARKER MD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 11/21/2017
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Provider Practice Location Address
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Address Line | 255 MONMOUTH RD
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City | OAKHURST
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State | NJ
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Zip | 07755-1515
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Country | US
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Telephone | 732-531-5445
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Fax | 732-531-1776
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Provider Business Mailing Address
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Address Line | 255 MONMOUTH RD
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City | OAKHURST
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State | NJ
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Zip | 07755-1515
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Country | US
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Telephone | 732-531-5445
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Fax | 732-531-1776
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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 | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 25MA06049700
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License Number State | NJ
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