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General NPI Number Information
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NPI Number | 1598935900
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Entity Type | Individual
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Provider Name | EDSON OLIVER PARKER III M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 07/06/2009
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Provider Practice Location Address
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Address Line | 3131 LA CANADA ST
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City | LAS VEGAS
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State | NV
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Zip | 89169-2578
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Country | US
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Telephone | 702-303-2416
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Fax | 702-474-9420
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Provider Business Mailing Address
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Address Line | PO BOX 29209
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City | LAS VEGAS
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State | NV
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Zip | 89126-3209
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Country | US
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Telephone | 702-499-9994
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Fax | 702-474-9420
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 5322
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 5322
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 5322
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License Number State | NV
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