Individual
SEAN P PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
915 W GORDON ST STE B, THOMASTON, GA 30286-3427
(706) 647-7009
(706) 647-7014
Mailing address
915 W GORDON ST STE B, THOMASTON, GA 30286-3427
(706) 647-7009
(706) 647-7014
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003803
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100001646A
—
GA
05
—
100001646B
—
GA
05
—
100001646C
—
GA
05
—
100001646D
—
GA
Enumeration date
10/24/2006
Last updated
01/25/2023
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