Individual
DELANO PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1157 FORSYTH STREET, MACON, GA 31201
(478) 745-8581
(478) 328-0438
Mailing address
2400 BELLEVUE RD, SUITE 21-A, DUBLIN, GA 31021-2885
(478) 275-7202
(478) 274-8418
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002809
GA
363AM0700X
Medical Physician Assistant
002809
GA
363AS0400X
Surgical Physician Assistant
002809
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207981921
—
GA
01
—
DC4061
RAILROAD MEDICARE
GA
01
—
P00261015
RAILROAD MEDICARE
GA
Enumeration date
05/03/2006
Last updated
03/12/2015
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