Individual
DR. JACOB JOSEPH PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-5353
(405) 456-1555
Mailing address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-5353
(405) 456-1555
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25453
OK
2085R0202X
Diagnostic Radiology Physician
G8697
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163960001
—
AR
05
—
204448104
—
MO
01
—
P00403538
MEDICARE RAILROAD
MO
Enumeration date
02/11/2006
Last updated
06/12/2019
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