MEDICARE: MICHAEL E PARKER PA-C

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	363A00000X	Physician Assistant	PA0000000781	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4058697	OTHER	TN	BLUE CROSS OF TENNESSEE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568426567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL E PARKER PA-C

Provider Business Mailing Address
First Line	:	PO BOX 5
Second Line	:
City	:	HOHENWALD
State	:	TN
Zip	:	38462-0005
Country	:	US
Telephone Number	:	931-796-7960
Fax Number	:	931-796-7790

Provider Business Practice Location Address
First Line	:	20 S PARK ST
Second Line	:
City	:	HOHENWALD
State	:	TN
Zip	:	38462-1413
Country	:	US
Telephone Number	:	931-796-7960
Fax Number	:	931-796-7790

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	05/20/2010

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Directions to “ MICHAEL E PARKER PA-C” Practice Location

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