Provider Demographics
NPI:1093855066
Name:SIMON, PARKER L (DO, MPH)
Entity type:Individual
Prefix:DR
First Name:PARKER
Middle Name:L
Last Name:SIMON
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1120 S UTICA AVE STE 2123
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4012
Mailing Address - Country:US
Mailing Address - Phone:918-579-5402
Mailing Address - Fax:918-579-5404
Practice Address - Street 1:1120 S UTICA AVE
Practice Address - Street 2:SUITE 2123
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104
Practice Address - Country:US
Practice Address - Phone:918-579-5402
Practice Address - Fax:918-579-5404
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2019-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK42272080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine