Individual
SCOTT J PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404
(208) 529-6111
Mailing address
2265 E SUNNYSIDE RD, IDAHO FALLS, ID 83404-7598
(208) 542-5000
(208) 542-5151
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
8809928-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
M-13992
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730447186
—
ID
Enumeration date
04/23/2012
Last updated
05/14/2018
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