Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 4301084487 | MI |
Y | 208200000X | Surgeon | 8454A | WY |
Y | 208600000X | Surgeon | 8454A | WY |
N | 2086S0102X | Surgical Critical Care | 8454A | WY |
N | 2086S0127X | Trauma Surgeon | 8454A | WY |
N | 2086S0129X | Vascular Surgeon | 8454A | WY |
N | 2086X0206X | Surgical Oncologist | 8454A | WY |
N | 208C00000X | Colorectal Surgeon | 8454A | WY |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 8454A | WY |
NPI | 1447469135 |
---|---|
Provider Name | Dr. Alton Parker |
First Address | Jackson, WY 83001-3998 |
Second Address | Jackson, WY 83001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 26/01/2012 |