Provider Demographics
NPI:1114362688
Name:PARKER, WALTER TYSON (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:TYSON
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 19TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4804
Mailing Address - Country:US
Mailing Address - Phone:205-930-0700
Mailing Address - Fax:205-930-9127
Practice Address - Street 1:1000 19TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205
Practice Address - Country:US
Practice Address - Phone:205-930-0700
Practice Address - Fax:205-930-9127
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN61757207W00000X
AL37065207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology