Individual
NOAH PHILLEO PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11725 ILLINOIS ST STE 275, CARMEL, IN 46032-3009
(317) 688-4864
(317) 688-4884
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01073891A
IN
207X00000X
Orthopaedic Surgery Physician
01082693A
IN
207Y00000X
Otolaryngology Physician
Primary
01073891A
IN
208600000X
Surgery Physician
256391
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063220036
MEDICARE
IN
05
—
201234960
—
IN
01
—
IN1585003
MEDICARE
IN
Enumeration date
04/07/2008
Last updated
12/13/2022
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