Individual
BRENT ALAN PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
(765) 838-4758
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01090848A
IN
207L00000X
Anesthesiology Physician
M2741
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004PH
BLUE SHIELD
TX
01
—
1103150970
ANTHEM PTAN
IN
01
—
264430I12
MEDICARE PTAN
IN
05
—
300081598
—
IN
01
—
815500693
MEDICARE PTAN
IN
01
—
8M2468
MEDICARE
TX
01
—
Q00572843
RAILROAD PTAN
IN
Enumeration date
03/20/2007
Last updated
03/02/2026
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