Provider Demographics
NPI:1386648194
Name:PARKER, JOHN W JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:PARKER
Suffix:JR
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 1:322 WILD OAK DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-8228
Mailing Address - Country:US
Mailing Address - Phone:318-426-8884
Mailing Address - Fax:
Practice Address - Street 1:322 WILD OAK DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-8228
Practice Address - Country:US
Practice Address - Phone:318-426-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013620207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA040007485OtherRAILROAD MEDICARE NUMBER
LA1053315846OtherGROUP NPI NUMBER
LA1311588Medicaid
LA040007485OtherRAILROAD MEDICARE NUMBER
LA1053315846OtherGROUP NPI NUMBER
LA1311588Medicaid