Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 4376 | OK |
N | 1223P0221X | Pediatric Dentist | 47 | OK |
N | 1223X0400X | Orthodontists | 118 | OK |
NPI | 1063522803 |
---|---|
Provider Name | Dr. Phillip R Parker |
First Address | Norman, OK 73072 |
Second Address | Norman, OK 73072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |