Individual
DR. JONATHAN PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 N MAESTRI RD, SUITE 1, SPRINGDALE, AR 72762-9818
(479) 361-1020
(479) 361-9118
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 361-1020
(479) 361-9118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-4638
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160764001
—
AR
01
—
5N513
AR BC/BS
AR
01
—
P00424746
RR MCR
AR
Enumeration date
05/17/2006
Last updated
12/15/2021
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