Individual
TY PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSN
Contact information
Practice address
625 N MAIN ST, HATTIESBURG, MS 39401-3429
(228) 264-0163
Mailing address
625 N MAIN ST, HATTIESBURG, MS 39401-3429
(228) 264-0163
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
MS
Other
Enumeration date
01/08/2026
Last updated
01/08/2026
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