Provider Demographics
NPI:1841420973
Name:PARKER, LAKEISHA N (OD)
Entity type:Individual
Prefix:DR
First Name:LAKEISHA
Middle Name:N
Last Name:PARKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 E 8 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-1010
Mailing Address - Country:US
Mailing Address - Phone:313-366-5100
Mailing Address - Fax:313-366-5104
Practice Address - Street 1:2424 E 8 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-1495
Practice Address - Country:US
Practice Address - Phone:313-366-3290
Practice Address - Fax:313-366-7313
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004525152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist