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NPI Code Detail

MEDICARE: DR. SANDRA PARKER M.D.

MEDICARE: DR. SANDRA PARKER 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
12084P0800XPsychiatry Physician00013404AL

General Provider Information

NPI Number : 1982606976
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SANDRA PARKER M.D.
Provider Business Mailing Address
First Line : 5750A SOUTHLAND DR
Second Line :
City : MOBILE
State : AL
Zip : 36693-3316
Country : US
Telephone Number : 251-450-5901
Fax Number : 251-662-7297
Provider Business Practice Location Address
First Line : 5800 SOUTHLAND DR
Second Line :
City : MOBILE
State : AL
Zip : 36693-3313
Country : US
Telephone Number : 251-661-0153
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 05/29/2020

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