Provider Demographics
NPI:1194704189
Name:PARKER, GAIL MARIE (MPT)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:MARIE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:MARIE
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1115 TAMARACK RD
Mailing Address - Street 2:STE 800
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301
Mailing Address - Country:US
Mailing Address - Phone:270-689-2341
Mailing Address - Fax:270-689-2342
Practice Address - Street 1:1115 TAMARACK RD
Practice Address - Street 2:STE 800
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301
Practice Address - Country:US
Practice Address - Phone:270-689-2341
Practice Address - Fax:270-689-2342
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY87900544Medicaid
KY5029801Medicare ID - Type Unspecified