Provider Demographics
NPI:1427431873
Name:PARKER, COLLIN ROBERT (MD)
Entity type:Individual
Prefix:
First Name:COLLIN
Middle Name:ROBERT
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 FARNAM ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2850
Mailing Address - Country:US
Mailing Address - Phone:402-552-2555
Mailing Address - Fax:402-552-2598
Practice Address - Street 1:4242 FARNAM ST
Practice Address - Street 2:SUITE 360
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2850
Practice Address - Country:US
Practice Address - Phone:402-552-2555
Practice Address - Fax:402-552-2598
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE33431207N00000X
NJ25MA10560900207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology