Provider Demographics
NPI:1528247327
Name:PARKER, HALEY S (OD)
Entity type:Individual
Prefix:DR
First Name:HALEY
Middle Name:S
Last Name:PARKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 WAYNE MEMORIAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-2255
Mailing Address - Country:US
Mailing Address - Phone:919-734-8998
Mailing Address - Fax:919-734-8976
Practice Address - Street 1:1318 WAYNE MEMORIAL DR STE C
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2255
Practice Address - Country:US
Practice Address - Phone:919-734-8998
Practice Address - Fax:919-734-8976
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2067152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC093W7OtherBLUE CROSS BLUE SHIELD
NC204180OtherMEDCOST
NC5908327Medicaid
NC204180OtherMEDCOST