Individual
MR. KAIMAN WILL PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
950 MATTHEW DR, WAYNESBORO, MS 39367-2567
(601) 596-5526
Mailing address
30 CRIMSON LN, PETAL, MS 39465-5809
(601) 596-5526
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA00728
MS
208M00000X
Hospitalist Physician
PA00728
MS
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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