MEDICARE: DR. HALEY S PARKER OD

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	152W00000X	Optometrist	2067	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	093W7	OTHER	NC	BLUE CROSS BLUE SHIELD
2	204180	OTHER	NC	MEDCOST
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528247327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HALEY S PARKER OD

Provider Business Mailing Address
First Line	:	1318 WAYNE MEMORIAL DR STE C
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-2255
Country	:	US
Telephone Number	:	919-734-8998
Fax Number	:	919-734-8976

Provider Business Practice Location Address
First Line	:	1318 WAYNE MEMORIAL DR STE C
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-2255
Country	:	US
Telephone Number	:	919-734-8998
Fax Number	:	919-734-8976

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

Provider Enumeration Date	:	10/29/2007
Last Update Date	:	01/10/2012

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