Provider Demographics
NPI:1841219391
Name:PARKER, JAMES L (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
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 452
Mailing Address - Street 2:
Mailing Address - City:ALICEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35442-0452
Mailing Address - Country:US
Mailing Address - Phone:205-373-1574
Mailing Address - Fax:205-373-2653
Practice Address - Street 1:100 5TH ST NE
Practice Address - Street 2:
Practice Address - City:ALICEVILLE
Practice Address - State:AL
Practice Address - Zip Code:35442-2200
Practice Address - Country:US
Practice Address - Phone:205-373-1574
Practice Address - Fax:205-373-2653
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21969207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051510250OtherBLUECROSS BLUESHIELD
AL051510250Medicaid
AL0112401OtherUNITED HEALTH
AL102I080290Medicare PIN
AL0112401OtherUNITED HEALTH
G83382Medicare UPIN