Individual
JOHN TYLER PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
1600 GOVERNORS DR APT 811, PENSACOLA, FL 32514-9437
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
PARK-LNKR7G
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2025
Last updated
06/03/2025
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