MEDICARE: RYON EUGENE 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	208000000X	Pediatrics Physician	14781	NV
2	207R00000X	Internal Medicine Physician	14781	NV

General Provider Information

NPI Number	:	1609001759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYON EUGENE PARKER MD

Provider Business Mailing Address
First Line	:	5380 S RAINBOW BLVD STE 236
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1879
Country	:	US
Telephone Number	:	702-778-2204
Fax Number	:	702-688-4371

Provider Business Practice Location Address
First Line	:	5380 S RAINBOW BLVD STE 236
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1879
Country	:	US
Telephone Number	:	702-778-2204
Fax Number	:	702-688-4371

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

Provider Enumeration Date	:	05/19/2009
Last Update Date	:	01/25/2023

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