Individual
GREGORY G PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1220 JEFFERSON ST, LAUREL, MS 39440-4355
(601) 426-4000
(601) 399-6281
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 399-6100
(601) 399-6281
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R791344
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04078379
—
MS
Enumeration date
08/13/2006
Last updated
04/06/2015
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