Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 0103000907 | VA |
Y | 222Z00000X | Podiatrist | 0103000907 | VA |
N | 213ES0131X | Foot Surgery | 0103000907 | VA |
NPI | 1396789806 |
---|---|
Provider Name | Dr. Jules Gerard Parker |
First Address | Chesapeake, VA 23323-6359 |
Second Address | Norfolk, VA 23504-4055 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 30/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9303693 | (05) | VA |
U42660 | (02) | VA |
VAA100791 | MEDICARE PTAN (01) | VA |