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General NPI Number Information
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NPI Number | 1720168032
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Entity Type | Organization
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Legal Business Name | CHARLES H PARKER JR MD PC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 04/02/2013
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Provider Practice Location Address
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Address Line | 45 MAIN ST
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City | HALIFAX
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State | VA
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Zip | 24558-3211
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Country | US
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Telephone | 434-476-1220
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Fax | 434-476-1440
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Provider Business Mailing Address
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Address Line | PO BOX 397
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City | SOUTH BOSTON
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State | VA
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Zip | 24592-0397
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Country | US
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Telephone | 434-476-1220
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Fax | 434-476-1440
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES H. PARKER JR.
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Credential | M.D.
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Telephone | 434-476-1220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 0101041330
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License Number State | VA
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