Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 34972 | KY |
NPI | 1003816497 |
---|---|
Provider Name | James W. Parker |
First Address | Louisville, KY 40223-2992 |
Second Address | Somerset, KY 42501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 20/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116304 | PROVIDER NUMBER (01) | KY |
50001588 | (05) | KY |
64002819 | (05) | KY |
G91294 | (02) | |
G91294 | (02) | KY |