Provider Demographics
NPI:1750342788
Name:PARKER, JANINE STECKLER (MD)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:STECKLER
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 GAUSE BLVD STE 360
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2999
Mailing Address - Country:US
Mailing Address - Phone:985-641-5523
Mailing Address - Fax:985-645-9411
Practice Address - Street 1:1051 GAUSE BLVD STE 360
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2999
Practice Address - Country:US
Practice Address - Phone:985-641-5523
Practice Address - Fax:985-645-9411
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019118207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1389188Medicaid
MS01080551Medicaid
LA1389188Medicaid
LA5J789Medicare PIN
F34720Medicare UPIN