Provider Demographics
NPI:1982773495
Name:PARKER, JEFFRY T (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFRY
Middle Name:T
Last Name:PARKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 E HAMPDEN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-3000
Mailing Address - Country:US
Mailing Address - Phone:303-758-0224
Mailing Address - Fax:303-758-2633
Practice Address - Street 1:6825 E HAMPDEN AVE STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3000
Practice Address - Country:US
Practice Address - Phone:303-758-0224
Practice Address - Fax:303-758-2633
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2329111N00000X, 111NN1001X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2628Medicare ID - Type Unspecified