Basic Information
Provider Information
NPI: 1518142843
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARKER
FirstName: JOHN
MiddleName: ROBERT
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5450 FRANTZ RD
Address2: STE 360
City: DUBLIN
State: OH
PostalCode: 430164134
CountryCode: US
TelephoneNumber: 6145446155
FaxNumber: 6145446370
Practice Location
Address1: 5193 W BROAD ST STE 200
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432281695
CountryCode: US
TelephoneNumber: 6147883700
FaxNumber: 6148787005
Other Information
ProviderEnumerationDate: 01/05/2008
LastUpdateDate: 01/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XN8235TXN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000X35.092402OHY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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