Individual
REBECCA PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-7005
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
008275
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008275
RTP
GA
Enumeration date
06/04/2016
Last updated
06/04/2016
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