MEDICARE: JEFFREY CARL 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	207X00000X	Orthopaedic Surgery Physician	4625	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437160173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY CARL PARKER MD

Provider Business Mailing Address
First Line	:	4100 LAKE OTIS PKWY, SUITE 308
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508
Country	:	US
Telephone Number	:	907-563-2663
Fax Number	:	907-333-2948

Provider Business Practice Location Address
First Line	:	4100 LAKE OTIS PKWY, SUITE 308
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508
Country	:	US
Telephone Number	:	907-563-2663
Fax Number	:	907-333-2948

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	11/16/2015

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