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NPI Code Detail

MEDICARE: DR. AUTRY JAMES PARKER JR. M.D.

MEDICARE: DR. AUTRY JAMES PARKER JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMD23740TN

General Provider Information

NPI Number : 1154326403
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AUTRY JAMES PARKER JR. M.D.
Provider Business Mailing Address
First Line : 6325 HUMPHREYS BLVD
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-2300
Country : US
Telephone Number : 901-522-7700
Fax Number : 901-259-0130
Provider Business Practice Location Address
First Line : 6325 HUMPHREYS BLVD
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-2300
Country : US
Telephone Number : 901-522-7700
Fax Number : 901-259-0130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 03/08/2011

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