# DR. JACOB C. PARKER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1326510751
- **Gender:** Man
- **Credential:** DO, MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TP0814X | Psychoanalysis Psychologist | 8420042213 | IL | — |
| 163WC0400X | Case Management Registered Nurse | MS80885 | MS | — |
| 246Z00000X | Other Specialist/Technologist | 800341120 | HI | — |
| 246Z00000X | Other Specialist/Technologist | 800341120 | MS | Yes |

## Other

- **Enumeration date:** 12/24/2018
- **Last updated:** 11/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 251123217211 | CLIA LICENSES | MS |
| 01 | — | 25187411 | CLINICAL LABORATORY IMPROVEMENT AMENDMENTS | MS |
| 05 | — | 314125401870 | — | MS |
| 05 | — | 7NQ3-KD9-CK19 | — | MS |
| 05 | — | 800341120 | — | MS |
| 01 | — | MS80885 | MEDICAL LICENSES | MS |