Provider Demographics
NPI:1275350092
Name:PARKER, AZAZIAH CHANTE (MD)
Entity type:Individual
Prefix:
First Name:AZAZIAH
Middle Name:CHANTE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 MANCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:PEARL
Mailing Address - State:MS
Mailing Address - Zip Code:39208-9370
Mailing Address - Country:US
Mailing Address - Phone:601-862-1272
Mailing Address - Fax:
Practice Address - Street 1:512 MANCHESTER DR
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-9370
Practice Address - Country:US
Practice Address - Phone:601-862-1272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program