Provider Demographics
NPI:1326076795
Name:PARKER, PRIOR LEWIS (MD)
Entity Type:Individual
Prefix:
First Name:PRIOR
Middle Name:LEWIS
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 1:17 WELLS ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2923
Mailing Address - Country:US
Mailing Address - Phone:401-596-0339
Mailing Address - Fax:401-596-3437
Practice Address - Street 1:200 SANDY HOLLOW RD
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-1720
Practice Address - Country:US
Practice Address - Phone:860-536-4916
Practice Address - Fax:860-536-3247
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031338207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NLS023OtherOXFORD
AA33963OtherHARVARD PILGRIM HEALTH
180000515OtherDMERC
CT001313387Medicaid
RI004298OtherBLUECHIP
180000515OtherRAILROAD MEDICARE
000000002011OtherNEIGHBORHOOD HEALTH PLAN
RI0000002064OtherBLUE SHIELD
CT010031338CT01OtherBLUESHIELD OF CT
030080OtherHEALTHNET
966013OtherUNITED HEALTH CARE
030080OtherHEALTHNET
AA33963OtherHARVARD PILGRIM HEALTH
966013OtherUNITED HEALTH CARE