Individual
RUSSELL KENNETH PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1613 BAYITA LN NW, ALBUQUERQUE, NM 87107-3320
(505) 269-4669
Mailing address
1613 BAYITA LN NW, ALBUQUERQUE, NM 87107-3320
(505) 269-4669
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
99277
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z6244
—
NM
Enumeration date
02/24/2006
Last updated
06/28/2016
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