Provider Demographics
NPI:1558416677
Name:PARKER, CARMAN ANN (DO)
Entity Type:Individual
Prefix:MRS
First Name:CARMAN
Middle Name:ANN
Last Name:PARKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2917
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-2917
Mailing Address - Country:US
Mailing Address - Phone:606-437-2121
Mailing Address - Fax:606-433-1867
Practice Address - Street 1:1098 S MAYO TRL
Practice Address - Street 2:SUITE 301
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1546
Practice Address - Country:US
Practice Address - Phone:606-437-2121
Practice Address - Fax:606-433-1867
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02855103TA0400X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64108129Medicaid
KY0939402Medicare PIN
I32088Medicare UPIN
KY0939402Medicare ID - Type Unspecified