Provider Demographics
NPI:1023184231
Name:PARKER, GARLANDA LEA (MD)
Entity Type:Individual
Prefix:DR
First Name:GARLANDA
Middle Name:LEA
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13321 N MERIDIAN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8356
Mailing Address - Country:US
Mailing Address - Phone:405-749-9216
Mailing Address - Fax:405-749-9210
Practice Address - Street 1:13321 N MERIDIAN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8356
Practice Address - Country:US
Practice Address - Phone:405-749-9216
Practice Address - Fax:405-749-9210
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK16134208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100106660AMedicaid