Provider Demographics
NPI:1699817700
Name:PARKER, JOHN MCCOMB (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MCCOMB
Last Name:PARKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 48TH STREET CT W
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-9378
Mailing Address - Country:US
Mailing Address - Phone:941-721-7104
Mailing Address - Fax:
Practice Address - Street 1:4343 HENDERSON BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5657
Practice Address - Country:US
Practice Address - Phone:813-254-5200
Practice Address - Fax:813-254-5278
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8921111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor