Provider Demographics
NPI:1346298973
Name:PARKER, LISA ML (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ML
Last Name:PARKER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:104 RHODES AVE
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-9656
Mailing Address - Country:US
Mailing Address - Phone:252-794-3042
Mailing Address - Fax:252-794-2911
Practice Address - Street 1:101 KELLIE DR
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-9443
Practice Address - Country:US
Practice Address - Phone:919-938-3749
Practice Address - Fax:919-938-3749
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9901279208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891223VMedicaid
NC891223VMedicaid