Provider Demographics
NPI:1518937028
Name:PARKER, CECIL L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CECIL
Middle Name:L
Last Name:PARKER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2866 DAUPHIN STREET
Mailing Address - Street 2:SUITE V
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606
Mailing Address - Country:US
Mailing Address - Phone:251-470-0552
Mailing Address - Fax:251-470-0896
Practice Address - Street 1:2866 DAUPHIN ST
Practice Address - Street 2:SUITE V
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-2486
Practice Address - Country:US
Practice Address - Phone:251-470-0552
Practice Address - Fax:251-470-0896
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2010-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00010892207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000015675Medicaid
AL000015675Medicare ID - Type Unspecified
ALC73841Medicare UPIN