Provider Demographics
NPI:1376513796
Name:PARKER, AUSTIN LYLE (MD)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:LYLE
Last Name:PARKER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:NMRTC PORTSMOUTH - NEPHROLOGY CLINIC
Mailing Address - Street 2:620 JOHN PAUL JONES CIRCLE
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23708
Mailing Address - Country:US
Mailing Address - Phone:757-953-2051
Mailing Address - Fax:757-953-8000
Practice Address - Street 1:881 USS JAMES MADISON RD
Practice Address - Street 2:NSSC UNDERSEA MEDICAL DEPARTMENT
Practice Address - City:KINGS BAY
Practice Address - State:GA
Practice Address - Zip Code:31547-2531
Practice Address - Country:US
Practice Address - Phone:912-573-2995
Practice Address - Fax:912-573-4534
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2022-09-23
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Provider Licenses
StateLicense IDTaxonomies
VA0101234675208D00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice