Provider Demographics
NPI:1972062974
Name:PARRACK, PAIGE HUNTER
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:HUNTER
Last Name:PARRACK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 STANTON L. YOUNG BLVD
Mailing Address - Street 2:BMSB 451
Mailing Address - City:OKC
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5020
Mailing Address - Country:US
Mailing Address - Phone:405-271-2422
Mailing Address - Fax:
Practice Address - Street 1:940 STANTON L. YOUNG BLVD
Practice Address - Street 2:BMSB 451
Practice Address - City:OKC
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-271-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2024-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK42997207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology