Provider Demographics
NPI:1124387139
Name:PARKER, IAN CHASE (DO)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:CHASE
Last Name:PARKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03581-1502
Mailing Address - Country:US
Mailing Address - Phone:603-466-2741
Mailing Address - Fax:603-466-2953
Practice Address - Street 1:2 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:NH
Practice Address - Zip Code:03581-1502
Practice Address - Country:US
Practice Address - Phone:603-466-2741
Practice Address - Fax:603-466-2953
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHEL07728204D00000X, 207Q00000X
ARE-10247207Q00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM