Individual
DARRELL R PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2825 HUNTERS TRL, 1ST FLOOR, PORTAGE, WI 53901-3429
(608) 742-7161
(608) 725-3060
Mailing address
2825 HUNTERS TRL, PORTAGE, WI 53901-3429
(608) 742-7161
(608) 475-3060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
76-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1022697
PHYSICIANS PLUS
WI
05
—
42967300
—
WI
01
—
5878
DEAN HEALTH INSURANCE
WI
Enumeration date
05/04/2006
Last updated
05/05/2008
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