Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 0101017463 | VA |
Y | 111NI0900X | Internist | 0101017463 | VA |
NPI | 1003243627 |
---|---|
Provider Name | Dr. Clifton Linwood Parker |
First Address | Richmond, VA 23227 |
Second Address | Richmond, VA 23227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2013 |
Last Update Date | 27/09/2013 |