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General NPI Number Information
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NPI Number | 1700689965
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Entity Type | Individual
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Provider Name | MARY ASHLYN PARKER MD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 145 SUNSET CT STE 100
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-2464
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Country | US
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Telephone | 803-739-3550
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Fax |
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Provider Business Mailing Address
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Address Line | 124 CRAWFORD LAKE DR
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City | EASLEY
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State | SC
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Zip | 29642-7886
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Country | US
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Telephone | 864-561-1091
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LL94637
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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