# PARKER FAMILY PRACTICE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487880712
- **Authorized official:** RONALD D PARKER MD (PROVIDER/OWNER)
- **Authorized official phone:** (928) 669-9700

## Contact information

- **Practice address:** 1713 S KOFA AVE, SUITE A, PARKER, AZ 85344-6477
- **Practice address phone:** (928) 669-9700
- **Practice address fax:** (928) 669-7104
- **Mailing address:** 1713 S KOFA AVE, SUITE A, PARKER, AZ 85344-6477
- **Mailing address phone:** (928) 669-9700
- **Mailing address fax:** (928) 669-7104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 36577 | AZ | Yes |

## Other

- **Enumeration date:** 06/01/2009
- **Last updated:** 06/01/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 227740 | — | AZ |