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Individual
KENNETH R PARKER
Active
Individual
KENNETH R PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01037962A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
01037962A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042725
BLUE SHIELD
IN
01
—
050052833
RAILROAD MEDICARE
—
05
—
100334280
—
IN
05
—
64872856
—
KY
Enumeration date
05/13/2006
Last updated
10/22/2020
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