Parker, Derrall Shawn
Parker, Derrall Shawn is an individual health care provider with primary practice located at 360 S Mount Auburn Rd , Cape Girardeau MO 63703-4920. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Parker, Derrall Shawn can be contacted via phone (573) 335-3577.Contact Information
Primary practice address
360 S Mount Auburn Rd
Cape Girardeau MO 63703-4920
Phone: (573) 335-3577
Fax: (573) 335-1559
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | KY30522 | Kentucky |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD116562 | Missouri |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 036-101500 | Missouri |
Profile Details
| NPI number | 1700850500 |
|---|---|
| LBN Legal business name | Parker, Derrall Shawn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 16th, 2006 |
| Last updated | Jul 3rd, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700850500 | NPPES |
| Missouri | Other | 115309 | BC BS MO 43.1804777 |
| Missouri | Other | 1238355 | BC BS MO 43.1804777 |
| Missouri | Other | 180035388 | BC BS MO 43.1804777 |
| Missouri | Other | 5971604 | BC BS MO 43.1804777 |
| Missouri | Other | 180042674 | BC BS MO 43.1804777 |
| Missouri | Other | 393192 | BC BS MO 43.1804777 |
| Missouri | Other | P00288000 | BC BS MO 43.1804777 |
| Missouri | Other | 180035389 | BC BS MO 43.1804777 |
| Missouri | MEDICAID | 205249600 | BC BS MO 43.1804777 |
| Missouri | Other | 000000112968 | BC BS MO 43.1804777 |
| Missouri | MEDICAID | 64012115 | BC BS MO 43.1804777 |
| Missouri | Other | 393192 | BC BS MO 43.1804777 |
| Missouri | Other | G48960 | BC BS MO 43.1804777 |
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