Individual
GANNON PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
10101 RIDGEGATE PKWY, LONE TREE, CO 80124-5522
(720) 255-1000
Mailing address
10101 RIDGEGATE PKWY, LONE TREE, CO 80124-5522
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0008509
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/24/2022
Last updated
04/29/2024
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