Individual
MISS DEBORAH J. KONKLE-PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2500 NORTH STATE STREET, DEPARTMENT OF MEDICINE/DIVISION OF INFECTIOUS DISEASE, JACKSON, MS 39216-4500
(601) 984-5560
Mailing address
2500 NORTH STATE STREET, UNIVERSITY PHYSICIANS PLLC, JACKSON, MS 39216-4500
(601) 984-5560
(601) 984-5565
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
R795171
MS
363L00000X
Nurse Practitioner
Primary
R795171
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0118355
—
MS
01
—
P01745486
RAILROAD MEDICARE
MS
Enumeration date
07/10/2006
Last updated
07/18/2023
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