Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 07695 | MS |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 07695 | MS |
NPI | 1750489092 |
---|---|
Provider Name | Dr. Gregg Scott Parker |
First Address | Gulfport, MS 39503-9055 |
Second Address | Pineville, LA 71360-4044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |