Provider Demographics
NPI:1316692767
Name:PARKER, ROBERT RYAN
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:RYAN
Last Name:PARKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 HALL ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:OK
Mailing Address - Zip Code:73051-9514
Mailing Address - Country:US
Mailing Address - Phone:918-759-8224
Mailing Address - Fax:
Practice Address - Street 1:1000 YUKON AVE
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-4690
Practice Address - Country:US
Practice Address - Phone:405-265-3444
Practice Address - Fax:405-577-5488
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator