MEDICARE: JEFFERY MITCHELL PARKER PA

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	363A00000X	Physician Assistant	15-02535	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15418963	OTHER	KS	CAQH ID 15418963

General Provider Information

NPI Number	:	1487224036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFERY MITCHELL PARKER PA

Provider Business Mailing Address
First Line	:	2464 BROOKFIELD DR
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66503-1418
Country	:	US
Telephone Number	:	785-341-7305
Fax Number	:

Provider Business Practice Location Address
First Line	:	1133 COLLEGE AVE STE G100
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-2756
Country	:	US
Telephone Number	:	785-537-8710
Fax Number	:	785-537-0562

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

Provider Enumeration Date	:	06/27/2021
Last Update Date	:	11/01/2021

Similar Medicare Providers

1972574937 — HEARTLAND PAIN MANAGEMENT , LLC
Practice Location Address:

1133 COLLEGE AVE STE F100
MANHATTAN, KS
66502-2756

Practice Phone: 785-320-6700
Practice Fax:

1760453674 — ASSOCIATED UROLOGISTS, PA
Practice Location Address:

1133 COLLEGE AVE , BLDG G SUITE 100
MANHATTAN, KS
66502-2756

Practice Phone: 785-537-8710
Practice Fax: 785-537-0562

1538332788 — FELIPE ROSSO M.D.
Practice Location Address:

1133 COLLEGE AVE STE G100 , ASSOCIATED UROLOGISTS PA
MANHATTAN, KS
66502-2756

Practice Phone: 785-537-8710
Practice Fax: 785-537-0562

1124252523 — DEBRA K DELLERE OTR
Practice Location Address:

1133 COLLEGE AVE STE F100
MANHATTAN, KS
66502-2756

Practice Phone: 785-539-9669
Practice Fax: 785-539-9779

1306463773 — KIMBERLY MARIE KOCOUR MD
Practice Location Address:

1133 COLLEGE AVE STE G100
MANHATTAN, KS
66502-2756

Practice Phone: 785-537-8710
Practice Fax:

1669315941 — DAKOTA COY
Practice Location Address:

9912 LAVENDER LN
MANHATTAN, KS
66502-1531

Practice Phone: 785-370-6460
Practice Fax:

Directions to “ JEFFERY MITCHELL PARKER PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.