Provider Demographics
NPI:1225074396
Name:PARKER, ANNE V (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:V
Last Name:PARKER
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 1:121 HALTON VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6825
Mailing Address - Country:US
Mailing Address - Phone:864-286-3700
Mailing Address - Fax:864-286-6003
Practice Address - Street 1:121 HALTON VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6825
Practice Address - Country:US
Practice Address - Phone:864-286-3700
Practice Address - Fax:864-286-6003
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14400207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC144007Medicaid
SCE124913640Medicare PIN
SC144007Medicaid
SCE124917951Medicare PIN
E124910282Medicare PIN