Provider Demographics
NPI:1003887597
Name:PARKER, DAVID J (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:PARKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:11310 HURON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3046
Mailing Address - Country:US
Mailing Address - Phone:303-450-7435
Mailing Address - Fax:303-450-7463
Practice Address - Street 1:11310 HURON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-3046
Practice Address - Country:US
Practice Address - Phone:303-450-7435
Practice Address - Fax:303-450-7463
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2016-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO30772207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01307727Medicaid
COCJ0828Medicare PIN
CO01307727Medicaid
J0828Medicare ID - Type Unspecified