Parker, Jacob C.
Parker, Jacob C. is an sole proprietor health care provider with primary practice located at 300 Fairway Dr , Hattiesburg MS 39401-7715. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychoanalysis, Nursing Service Providers / Case Management, Technologists, Technicians & Other Technical Service Providers / Specialist/Technologist, Other. Technologists, Technicians & Other Technical Service Providers / Specialist/Technologist, Other is his primary health care specialty. Parker, Jacob C. can be contacted via phone (601) 307-5339.Contact Information
Primary practice address
300 Fairway Dr
Hattiesburg MS 39401-7715
Phone: (601) 307-5339
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychoanalysis | 103TP0814X | 8420042213 | Illinois |
| Nursing Service Providers / Case Management | 163WC0400X | MS80885 | Mississippi |
| Technologists, Technicians & Other Technical Service Providers / Specialist/Technologist, Other | 246Z00000X | 800341120 | Hawaii |
| Technologists, Technicians & Other Technical Service Providers / Specialist/Technologist, Other | 246Z00000X | 800341120 | Mississippi |
Profile Details
| NPI number | 1326510751 |
|---|---|
| LBN Legal business name | Parker, Jacob C. |
| Credentials | DO, MD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 24th, 2018 |
| Last updated | Apr 26th, 2024 - about last year |
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 | 1326510751 | NPPES |
| Mississippi | Other | 251123217211 | CLIA LICENSES |
| Mississippi | MEDICAID | 7NQ3-KD9-CK19 | CLIA LICENSES |
| Mississippi | MEDICAID | 800341120 | CLIA LICENSES |
| Mississippi | Other | 25187411 | CLIA LICENSES |
| Mississippi | Other | MS80885 | CLIA LICENSES |
| Mississippi | MEDICAID | 314125401870 | CLIA LICENSES |
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