Provider Demographics
NPI:1306803697
Name:PARKER, DAVID O (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:O
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 SEAGATE STE 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:567-585-1992
Mailing Address - Fax:419-824-7359
Practice Address - Street 1:2790 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-1252
Practice Address - Country:US
Practice Address - Phone:740-281-2576
Practice Address - Fax:740-281-2575
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2023-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35067661207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0213576Medicaid
OHG20981Medicare UPIN
OH0213576Medicaid