Individual
MARCUS L PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3708 NORTHSIDE DRIVE, MACON, GA 31210
(478) 745-4206
(478) 254-5324
Mailing address
102 LANCE DR, MACON, GA 31216-6170
(478) 320-6923
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004556
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
930868777A
—
GA
Enumeration date
08/08/2006
Last updated
10/25/2012
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