Provider Demographics
NPI:1255402376
Name:PARKER, HUBERT H IV (DMD)
Entity type:Individual
Prefix:DR
First Name:HUBERT
Middle Name:H
Last Name:PARKER
Suffix:IV
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 GEORGIAN DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-3432
Mailing Address - Country:US
Mailing Address - Phone:251-342-2324
Mailing Address - Fax:
Practice Address - Street 1:505 GEORGIAN DR
Practice Address - Street 2:SUITE B
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-3432
Practice Address - Country:US
Practice Address - Phone:251-342-2324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4597122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist