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Individual

JEFFERY MITCHELL PARKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1133 COLLEGE AVE STE G100, MANHATTAN, KS 66502-2756
(785) 537-8710
(785) 537-0562
Mailing address
2464 BROOKFIELD DR, MANHATTAN, KS 66503-1418
(785) 341-7305

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-02535
KS
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15418963
CAQH ID 15418963
KS
Enumeration date
06/27/2021
Last updated
11/01/2021
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