Provider Demographics
NPI:1174566574
Name:PARKER, L JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:L
Middle Name:JOSEPH
Last Name:PARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-6523
Mailing Address - Country:US
Mailing Address - Phone:870-777-8733
Mailing Address - Fax:870-495-2181
Practice Address - Street 1:502 E 24TH ST
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-3646
Practice Address - Country:US
Practice Address - Phone:870-826-7500
Practice Address - Fax:870-826-7500
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-1887207P00000X
ARE1887208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR135783001Medicaid
AR92-1989OtherSBMIC INSURANCE
AR0387634OtherCIGNA
AR5L025Medicare PIN
AR92-1989OtherSBMIC INSURANCE
AR5L025G254Medicare PIN