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Individual

PARKER GENE ESTVOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5811 JACK SPRINGS RD, ATMORE, AL 36502-5025
(251) 368-8630
Mailing address
2300 OLD MARTIN RD, BAKER, FL 32531-8518
(251) 368-9136
(251) 368-0832

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23316
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
23316
STATE LICENSE
AL
01
37487
STATE LICENSE
WA
05
631900009
AL
01
ME0033799
STATE LICENSE
FL
Enumeration date
08/30/2006
Last updated
07/08/2007
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