Provider Demographics
NPI:1962450874
Name:PARKER, BARRY MITCHELL (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:MITCHELL
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2480 CLAXTON DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-4427
Mailing Address - Country:US
Mailing Address - Phone:478-275-8634
Mailing Address - Fax:478-272-0538
Practice Address - Street 1:2406 BELLEVUE RD
Practice Address - Street 2:ERIN OFFICE PARK,BLDG 12
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2842
Practice Address - Country:US
Practice Address - Phone:478-275-0580
Practice Address - Fax:478-272-0538
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0331732085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00429338AMedicaid
GAB00058Medicare UPIN
GA00429338AMedicaid