Provider Demographics
NPI:1366658361
Name:PARKER, ALEXANDER THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:THOMAS
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:227 CREST ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4315
Mailing Address - Country:US
Mailing Address - Phone:734-274-3838
Mailing Address - Fax:
Practice Address - Street 1:623 W HURON ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6712
Practice Address - Country:US
Practice Address - Phone:734-274-2632
Practice Address - Fax:734-661-2668
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2520722084P0800X
MI43011062942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry