Individual
DR. JEREMIAH JASON PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.D.
Contact information
Practice address
7200 HALCYON SUMMIT DRIVE, MONTGOMERY, AL 36117
(334) 277-3492
(334) 277-9432
Mailing address
7200 HALCYON SUMMIT DRIVE, MONTGOMERY, AL 36117
(334) 277-3492
(334) 277-9432
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5169
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009942913
—
AL
05
—
009998947
—
AL
05
—
009998948
—
AL
01
—
51005746
BCBS ALABAMA
AL
01
—
51549243
BCBS OF ALABAMA
AL
Enumeration date
01/23/2007
Last updated
07/21/2022
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