Provider Demographics
NPI:1104211929
Name:PARKIN, ELIZABETH STARR (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:STARR
Last Name:PARKIN
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 1:11834 SEA STAR DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-9647
Mailing Address - Country:US
Mailing Address - Phone:317-849-5584
Mailing Address - Fax:
Practice Address - Street 1:11834 SEA STAR DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-9647
Practice Address - Country:US
Practice Address - Phone:317-849-5584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01029943A208D00000X
WV11657208D00000X
CAC40856208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice