Provider Demographics
NPI:1740889583
Name:MOLLY PARKER DO, PC
Entity type:Organization
Organization Name:MOLLY PARKER DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:LYNN SHELTERS
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-849-7100
Mailing Address - Street 1:216 OLDS ST
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49250-1128
Mailing Address - Country:US
Mailing Address - Phone:517-849-7100
Mailing Address - Fax:517-826-5211
Practice Address - Street 1:216 OLDS ST
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:MI
Practice Address - Zip Code:49250-1128
Practice Address - Country:US
Practice Address - Phone:517-849-7100
Practice Address - Fax:517-826-5211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty