Provider Demographics
NPI:1639259880
Name:PARKER, TAMMY A (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:A
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:A
Other - Last Name:PARKER-IJEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:419-226-5002
Mailing Address - Fax:419-998-4617
Practice Address - Street 1:1001 BELLEFONTAINE AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2800
Practice Address - Country:US
Practice Address - Phone:419-226-5002
Practice Address - Fax:419-998-4617
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076465207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1639259880OtherANTHEM BCBS
OH2159702Medicaid
OHPOO412498Medicare PIN
OH1639259880OtherANTHEM BCBS