Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 4227 | OK |
NPI | 1093855066 |
---|---|
Provider Name | Dr. Parker L Simon |
First Address | Tulsa, OK 74104-4012 |
Second Address | Tulsa, OK 74104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 11/11/2019 |