Parker, Kenneth R

Parker, Kenneth R is an sole proprietor health care provider with primary practice located at 1116 Millis Ave , Boonville IN 47601-2204. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Parker, Kenneth R can be contacted via phone (812) 473-0181.

Contact Information

Primary practice address
1116 Millis Ave Boonville IN 47601-2204
Phone: (812) 473-0181
Fax: (812) 473-5822
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 01037962A Indiana
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 01037962A Indiana

Profile Details

NPI number 1457302564
LBN Legal business name Parker, Kenneth R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 13th, 2006
Last updated Oct 22nd, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457302564 NPPES
Indiana MEDICAID 100334280
Indiana MEDICAID 64872856
Indiana Other 000000042725
Indiana Other 050052833

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