Provider Demographics
NPI:1083630750
Name:PARKER, LYNN P (MD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:P
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776347
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6347
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:676 S FLOYD ST STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1840
Practice Address - Country:US
Practice Address - Phone:502-629-4440
Practice Address - Fax:502-629-4445
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38911207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000341262OtherANTHEM PSC
KY50005114OtherPASSPORT SPECIALITY PSC
KY50005116OtherPASSPORT SPECIALITY FOUNDATION
KY64019045Medicaid
KY50005401OtherPASSPORT PCP FOUNDATION
KY000000342789OtherANTHEM FOUNDATION
IN200321090Medicaid
KY50005401OtherPASSPORT PCP FOUNDATION
KY50005114OtherPASSPORT SPECIALITY PSC
KY64019045Medicaid