Provider Demographics
NPI:1225077902
Name:PARKER, MITCHELL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:S
Last Name:PARKER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5055 E BROADWAY BLVD
Mailing Address - Street 2:STE A-100 ARIZONA COMMUNITY PHYSICIANS PC
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3640
Mailing Address - Country:US
Mailing Address - Phone:520-327-0460
Mailing Address - Fax:520-795-0225
Practice Address - Street 1:6365 E TANQUE VERDE RD
Practice Address - Street 2:STE 200
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3830
Practice Address - Country:US
Practice Address - Phone:520-886-5534
Practice Address - Fax:520-886-5577
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2010-02-26
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Provider Licenses
StateLicense IDTaxonomies
AZ11647207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D37416Medicare UPIN