Individual
COLETTE C PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5210
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5210
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
10781
MS
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
10781
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00019538
—
MS
05
—
1685127
—
LA
05
—
197520
—
AL
Enumeration date
06/21/2006
Last updated
04/22/2025
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