Individual
MR. JIM L PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
473 ELKS LODGE RD, PAWHUSKA, OK 74056-6542
(539) 212-2499
(539) 212-2468
Mailing address
473 ELKS LODGE RD, PAWHUSKA, OK 74056-6542
(539) 212-2499
(539) 212-2468
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
365
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
365
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
365
CADC
OK
Enumeration date
06/23/2008
Last updated
01/30/2026
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