MEDICARE: DR. RENDER HOWARD PARKMAN D.M.D.

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	122300000X	Dentist	8857	KY
2	122300000X	Dentist	DN014842	GA

General Provider Information

NPI Number	:	1871813030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENDER HOWARD PARKMAN D.M.D.

Provider Business Mailing Address
First Line	:	11416 SHELBYVILLE RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40243-1306
Country	:	US
Telephone Number	:	502-245-8442
Fax Number	:

Provider Business Practice Location Address
First Line	:	11416 SHELBYVILLE RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40243-1306
Country	:	US
Telephone Number	:	502-759-1429
Fax Number	:

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

Provider Enumeration Date	:	06/10/2010
Last Update Date	:	07/02/2015

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