Provider Demographics
NPI:1093571580
Name:PARKER PRIMARY CARE & AESTHETICS LLC
Entity Type:Organization
Organization Name:PARKER PRIMARY CARE & AESTHETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:765-717-1073
Mailing Address - Street 1:2452 S 1200 W
Mailing Address - Street 2:
Mailing Address - City:PARKER CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47368-9381
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2452 S 1200 W
Practice Address - Street 2:
Practice Address - City:PARKER CITY
Practice Address - State:IN
Practice Address - Zip Code:47368-9381
Practice Address - Country:US
Practice Address - Phone:765-717-1073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health