Provider Demographics
NPI:1558356360
Name:PARKER, RAY KOHLER JR (MD)
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:KOHLER
Last Name:PARKER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:9601 BAPTIST HEALTH DR.
Mailing Address - Street 2:SUITE 690
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6328
Mailing Address - Country:US
Mailing Address - Phone:501-227-8422
Mailing Address - Fax:501-537-2399
Practice Address - Street 1:5 MEDICAL PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3732
Practice Address - Country:US
Practice Address - Phone:501-776-3800
Practice Address - Fax:501-776-2209
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2024-02-13
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Provider Licenses
StateLicense IDTaxonomies
ARC7954207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR132947001Medicaid
AR070006372OtherRAILROAD MEDICARE
AR54622Medicare PIN
AR132947001Medicaid