MEDICARE: SARA MARIE PARKER MD

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207X00000X	Orthopaedic Surgery Physician	39595	OK

General Provider Information

NPI Number	:	1245804616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA MARIE PARKER MD

Provider Business Mailing Address
First Line	:	800 STANTON L YOUNG BLVD # 3422
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5018
Country	:	US
Telephone Number	:	405-271-4426
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 STANTON L YOUNG BLVD # 3422
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-5018
Country	:	US
Telephone Number	:	405-271-4426
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2021
Last Update Date	:	05/23/2022

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