Basic Information
| Provider Information | |||||||||
| NPI: | 1124387139 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARKER | ||||||||
| FirstName: | IAN | ||||||||
| MiddleName: | CHASE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 BROADWAY AVE | ||||||||
| Address2: | |||||||||
| City: | GORHAM | ||||||||
| State: | NH | ||||||||
| PostalCode: | 035811502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034662741 | ||||||||
| FaxNumber: | 6034662953 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 BROADWAY AVE | ||||||||
| Address2: | |||||||||
| City: | GORHAM | ||||||||
| State: | NH | ||||||||
| PostalCode: | 035811502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034662741 | ||||||||
| FaxNumber: | 6034662953 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2012 | ||||||||
| LastUpdateDate: | 10/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204D00000X | EL07728 | NH | N | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM | 207Q00000X | E-10247 | AR | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | EL07728 | NH | Y | Allopathic & Osteopathic Physicians | Family Medicine | 204D00000X | E-10247 | AR | N | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM |
No ID Information.